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

The primary use of laparoscopy is as a surgical tool, with sterilizations being the overwhelming indication. The laparoscope is used less frequently as a non-surgical tool, with the major indication being for diagnosing infertility and/or amenorrhea, and for evaluation of obscure pelvic pain. There would seem to be several indications for laparoscopy that have been neglected, these being in confirming the diagnosis of acute pelvic inflammatory disease; in the evaluation of malignancies and abdominal-pelvic trauma; and the surgical treatment of pelvic pain. Lapar-The majority of these contraindications are relative, and depend soley on the laparoscopist's ability and his clinical judgment. The problems of hernias seem to have been over-emphasized. The laparoscopist should be aware of potential problems with umbilical hernia, and he probably can ignore hiatal hernias except when they are large and quite symptomatic. However, generalized abdominal peritonitis, significant hemoperitoneum with intestinal obstruction are felt by most authors to be absolute contraindications. The most frequent complications of laparoscopy involve the physoperitoneum. Except for cardiac arrest the most serious complications involve electrical burns to small bowel.
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PMID:Indications, contraindications and complications of laparoscopy. 12 9

The clinical experience in diagnostic laparoscopy is dealt with under the conditions of the Department of Gynaecology and Obstetrics at Erlangen University. Among 700 cases the indications were infertility (34,4%), pelvic pain 27,4%), suspected ectopic pregnancy (7,9%), endocrinologic cases and malformations (18,9%), pelvic mass without symptoms (8,6%) and others (2,8%). The laparoscopic findings are shown. Important diagnostic clues otherwise missed were found in about half of the patients. In 122 women a laparotomy could be disregarded. One should be aware of diagnostic errors especially in ovarian tumors. Biopsy may help in assessment of ovarian function. In tumor diagnosis, however, it is rather dangerous. Difficulties of the methos (2,9%) and complications (1%) are discussed.
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PMID:[Report on 700 gynaecologic cases in diagnostic laparoscopy (author's transl)]. 12 14

Over the last 1 1/2 years diagnostic laparoscopy has been performed in 135 cases and laparoscopic tubal cauterization carried out in 15 patients. Indications and the diagnostic Value of the gynecological laparoscopy are discussed. In agreement with other authors, laparoscopy is found to have a definite place for the diagnosis of the following gynecological disorders and complaints: 1. Examination of fallopian tubes in cases of infertility, diagnosis of malformations of the genital organs and of grave functional disorders of the ovaries; 2. Possible ectopic pregnancy; 3. Differential diagnosis of pelvic mass; 4. Evaluation of chronic pelvic pain; 5. Differential diagnosis of acute diseases of pelvic and lower abdominal organs. Histological examinations of coagulated human fallopian tubes yielded information on the mechanism of action of this modern method of sterilization.
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PMID:[Position and significance of gynecologic laparoscopy]. 13 Jul 59

Laproscopic sterilization techniques and the diagnostic use of laparoscopy are discussed. In a series of 1000 laparoscopic sterilizations by the 2-incision technique, there was a total failure rate, surgical and operative, of .4%. In a similar series with the 1-incision technique and electrocagulation only, the total failure rate was 1.6%, though the complication rate was considerably reduced. The high failure rate was attributed to incomplete transection resulting in recanalization. The failure rate with a single-incision, 3-burn technique was .25% in a series of 2000 patients, and complications were few. Tubal occlusion with hemoclips has produced poor results (failure rate: 8-27%). The results with silastic bands, however, have been comparable to those for electrocoagulation, but with fewer complications. Means by which the cost of laparoscopic equipment may be reduced are discussed. Laparoscopy can be helpful in the diagnosis of infertility-endocrinology, ectopic pregnancy, pelvic pain, pelvic inflammatory disease, adnexal masses, and the retrieval of foreign bodies in the pelvic region. Contraindications to laparoscopy are reviewed. It is concluded that laparoscopy is a safe and effective means of sterilization on an outpatient basis, and is of value in the diagnosis of gynecologic disorders.
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PMID:Laparoscopy. 13 20

We present a series of 20 patients who underwent uterine suspension performed through a laparoscope, as part of conservative treatment for infertility and pelvic pain. The operative technique is easily mastered by a skilled laparoscopist who is prepared to deal with intra- or postoperative complications. Avulsion of the round ligament was the most serious complication experienced. Operating time was brief, and the hospital stay was short.
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PMID:Uterine suspension through the laparoscope. 14

Diagnostic laparoscopy is of most value in the evaluation of infertility and for completing the gynaecological investigation of obscure cases of chronic pelvic pain. Its use to exclude ectopic pregnancy, salpingitis and pelvic cancer is more controversial. The management of some cases of primary amenorrhoea is aided by laparoscopic gonadal biopsy. The excessive demand for female sterilization will ensure that the laparoscope continues to be used for this purpose and is leading to a compromise. The surgical techniques which have been proved to be most effective are being replaced by methods favoured for their potential reversibility and rapid patient turn-over. If all our laparoscopes were abandoned, gynaecological surgery would perhaps not suffer a major setback, but, for the present, those who neglect laparoscopy are losing an important dimension of modern practice.
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PMID:The use of laparoscopy in gynaecology. 15 14

Twenty-eight patients presenting with initial complaints of infertility or chronic pelvic pain were found to have pelvic endometriosis at laparoscopy. Destruction of the endometriotic lesions by means of electrocoagulation was performed via laparoscopy in a group of 19 patients. The remaining nine patients did not undergo such management. In the treatment group, seven of the 11 patients with chronic pain experienced complete relief of their symptoms, and six of the eight patients with infertility became pregnant postoperatively. Patients in the control group had a less favorable outcome. Only one of five patients with chronic pain had relief and one of four patients with infertility became pregnant following laparoscopy without cauterization. Electrocoagulation of pelvic endometriotic lesions under laparoscopic control appears to be satisfactory for the management of selected patients with chronic pelvic pain or infertility.
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PMID:Electrocoagulation of pelvic endometriotic lesions with laparoscopic control. 15 98

A multifactorial approach was used by the authors to analyze data from 119 women with endometriosis and infertility. Conservative surgical procedures afforded a mean pregnancy rate of 37.7 per cent for those women with significant disease. Only 6.7 per cent became pregnant when the proposed surgery was declined. There was an inverse relationship in severity of endometriotic involvement and pregnancy rate. The mean pregnancy rate among 17 patients with minimal disease for whom surgery was discouraged was 64.7 per cent; all pregnancies occurred within the first 2 years of follow-up. Relief of pelvic pain was dramatic, especially following presacral neurectomy. Laparoscopic selection of cases further reinforces the importance of grading severity of endometriosis prior to embarking on restorative surgery. Presacral neurectomy, despite reinforcement of pain relief, did not appear to contribute significantly to the occurrence of pregnancy.
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PMID:Pelvic endometriosis: infertility and pelvic pain. 60 6

Pelvic tuberculosis (TBC) was diagnosed in 20 patients studied during the years 1971 to 1975. Fourteen patients were born outside the United States. The most frequent presenting complaints were infertility (14 patients), pelvic pain (6), and amenorrhea (4). Only 5 patients gave a history of previous treatment for TBC. Results of pelvic examination were normal in 11 patients; results of chest X-rays were normal in 15. Sixteen patients had endometrial biopsies, 10 of which showed granulomatous endometritis. Fifteen patients had hysterosalpingograms, all of which yielded abnormal results, and 14 were indicative of TBC. Cultures were positive for Mycobacterium tuberculosis in 6 of 16 patients. Genital TBC should be considered as a possible cause of infertility, especially in foreign-born patients. Although a conclusive diagnosis can be made only from a positive culture or histologic specimen, hysterosalpingography is a very useful aid in establishing the diagnosis.
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PMID:Pelvic tuberculosis. 81 84

Three cases of coccidioidomycosis of the female genital tract are reviewed. The diagnosis was made by laparotomy in 2 patients who presented with tender adnexal masses, and by endometrical curettage in a third patient with disseminated coccidioidomycosis. Hysterectomies were performed in all 3 patients; 1 had a bilateral salpingo-oophorectomy and the others a bilteral salpingectomy and unilateral oophorectomy. Two patients received chemotherapy with amphotericin B. One patient died 4 years after her operation from disseminated and meningeal coccidioidomycosis. In a female patient who has resided in an endemic region and who presents with pelvic pain of obscure origin, unexplained infertility, a menstrual disorder, or a chronic, refractory pelvic inflammatory disease, genital coccidioidomycosis should be considered in the differential diagnosis.
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PMID:Female genital coccidioidomycosis. 111 94


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