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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From September 1993 to July 1995, 63 women (mean age 38 yrs, range 26-53 yrs, parity 0-7) with chronic pelvic pain (CPP) and menorrhagia underwent outpatient laparoscopic surgery and endometrial ablation. Operating time ranged from 9 to 110 minutes (mean 52 min). Laparoscopic procedures included excision of endometriosis (26), adhesiolysis (17), electromyolysis (4), uterine suspension (6), and appendectomy (4). At 6 to 20 months' follow-up 63 women reported no pain (24, 38.1%), significant improvement of pain (25, 39.7%), no change in amount of pain (9, 14.3%), and an increase of pain (5, 7.9%). Six patients had repeat laparoscopy. After hysteroscopic endometrial rollerball ablation and resection, the same women reported amenorrhea (31, 49.2%), hypomenorrhea (26, 41.3%), eumenorrhea (3, 4.8%), and no change in menstrual bleeding (3, 4.8%). Two women had a repeat endometrial ablation and one had hysterectomy for menorrhagia and CPP. Concomitant laparoscopic surgery and endometrial ablation is an effective alternative to hysterectomy for women with CPP and menorrhagia.
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PMID:Concomitant Laparoscopic Surgery and Hysteroscopic Endometrial Ablation for Women with Chronic Pelvic Pain and Menorrhagia 907 59

Forty patients due to undergo endometrial ablation as a treatment for dysfunctional uterine bleeding were recruited to assess the efficacy and safety of endometrial laser intrauterine thermo-therapy using the gynelase. At 12 months the average menstrual score reduction was 88%, the amenorrhoea rate was 70%, and the hypomenorrhoea rate 16%. Four women (10%) have had a hysterectomy for persistent menorrhagia, and one (3%) for pelvic pain. One patient (3%) has had a further endometrial laser ablation. There were no major complications. and 34 patients (85%) were most satisfied with the treatment. The system is easy to use and has a short learning curve.
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PMID:Endometrial laser intrauterine thermotherapy for the treatment of dysfunctional uterine bleeding: the first British experience. 1250 62

Asherman's syndrome is being diagnosed with increasing frequency. Although it usually occurs following curettage of the pregnant or recently pregnant uterus, any uterine surgery can lead to intrauterine adhesions (IUA). Most women with IUA have amenorrhea or hypomenorrhea, but up to a fourth have painless menses of normal flow and duration. Those who have amenorrhea may also have cyclic pelvic pain caused by outflow obstruction. The accompanying retrograde menstruation may lead to endometriosis. In addition to abnormal menses, infertility and recurrent spontaneous abortion are common complaints. Hysteroscopy is the standard method to both diagnose and treat this condition. Various techniques for adhesiolysis and for prevention of scar reformation have been advocated. The most efficacious appears to be the use of miniature scissors for adhesiolysis and the placement of a balloon stent inside the uterus immediately after surgery. Postoperative estrogen therapy is prescribed to stimulate endometrial regrowth. Follow-up studies to assure resolution of the scarring are mandatory before the patient attempts to conceive as is careful monitoring of pregnancies for cervical incompetence, placenta accreta, and intrauterine growth retardation.
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PMID:Asherman's syndrome. 2143 22

Intrauterine adhesions (IUA) or Asherman's syndrome is a multifaceted condition which is being diagnosed with increasing frequency. Although it usually occurs following curettage of the pregnant or recently pregnant uterus, any uterine surgery can lead to IUA. Most women with IUA have amenorrhoea or hypomenorrhoea, but some have normal menses. Those who have amenorrhoea may also have cyclic pelvic pain secondary to 'trapped' menses and the accompanying retrograde menstruation may lead to endometriosis. In addition to menstrual disorders, most women with IUA will present with infertility or recurrent spontaneous abortion. Over the last four decades hysteroscopy has become the standard method to diagnose and treat this condition. Various techniques for adhesiolysis and for prevention of scar reformation have been advocated. The most efficacious appears to be the use of miniature scissors for adhesiolysis and the placement of a balloon stent inside the uterus immediately after surgery. Post-operative oestrogen therapy is prescribed in order to stimulate endometrial regrowth. Follow-up studies to assure resolution of the IUA are mandatory before the patient attempts to conceive as is careful monitoring of pregnancies for cervical incompetence, placenta accreta and intrauterine growth restriction.
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PMID:Management of Asherman's syndrome. 2154 41