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

Repeated application of GnRH agonists causes a reversible suppression of ovarian function. Suppression on estrogen release is the fundamental idea of this hormonal therapy of endometriosis. We treated twelve patients with histologically proved endometriosis with leuprolide acetate depot in a dose of 3.75 mg s.c. every 4 weeks over a period of 6 months. In the first week of therapy the estrogen level decreased to a post-menopausal niveau along with amenorrhoea during the entire period of therapy. Complaints previous to therapy such as dysmenorrhoea, pelvic pain and dyspareunia were relieved or completely disappeared after therapy. The clinical finding on palpation also diminished or disappeared. In addition to this finding pelvis copy showed a shift from severe endometriosis stage III and stage IV to stage I and stage II of the AFS classification 1985. Regular menstruation appeared in 5 to 9 weeks after the last application to all patients. Out of six cases of infertility, four patients became pregnant. Except for one case, typical menopausal symptoms appeared, such as flush, increased perspiration and sleeping disorders. During and after therapy we could not prove any changes in the lipid metabolism under estrogen therapy. Mineralization of the bone decreased under therapy by about 3%. Simultaneously, serum osteocalcin increased. Demineralization occurred with one exception within the normal range for the corresponding age. With identical efficiency but less side effects, we see therapy with GnRH agonists as an alternative to current hormonal therapy of endometriosis.
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PMID:[GnRH-agonists in the therapy of endometriosis]. 212 66

Fifty patients with proven endometriosis were treated for 6 to 9 months with a delayed release preparation of microcapsules of the luteinizing hormone-releasing hormone (LH-RH) agonist D-Trp6-LH-RH, injected intramuscularly at monthly intervals. After a transitory ovarian stimulation at the onset of treatment, serum estradiol was suppressed to menopausal levels (50 pg/mL). This state of hypogonadism was reversible after the discontinuation of treatment, and menses resumed within 4 months after the last injection. Pelvic pain was relieved during treatment in 87.5% of patients. After a follow-up period of up to 37 months, 24 patients are in clinical remission and 9 experienced recurrence of endometriosis 7 to 14 months after completing treatment. One patient failed to respond to therapy with the agonist and 7 patients were lost to follow-up. Among 16 previously infertile patients with no other factors contributing to infertility, 7 became pregnant; 2 of these pregnancies were the result of gamete intrafallopian transfers. An eighth patient without documented infertility also conceived spontaneously. Side effects due to hypoestrogenism were reported by nearly all patients. In conclusion, D-Trp6-LH-RH microcapsules are effective and easily-administered agents for the treatment of endometriosis.
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PMID:Treatment of endometriosis with a delayed release preparation of the agonist D-Trp6-luteinizing hormone-releasing hormone: long-term follow-up in a series of 50 patients. 213 92

The American Association of Gynecologic Laparoscopists' (AAGL) 1988 membership survey on operative laparoscopy had a response rate of 24%. A total of 880 respondents reported performing 36,928 operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer procedures. The most frequently reported conditions managed with operative laparoscopy were endometrial implants, extensive adhesions and ovarian cysts. Most operative laparoscopies were performed because of infertility (40%) or pelvic pain (41%). The overall serious complication rate was 15.4 per 1,000 procedures. Complications that occurred in greater than 1 per 1,000 procedures included hospitalization greater than 72 hours, persistent human chorionic gonadotropin titer elevation after ectopic pregnancy, hospital readmission and unintended laparotomy to manage bowel injury, urinary tract injury or hemorrhage. Two deaths (5.4 per 100,000 procedures) were reported.
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PMID:American Association of Gynecologic Laparoscopists' 1988 membership survey on operative laparoscopy. 214 40

The American Association of Gynecologic Laparoscopists' (AAGL) 1988 Membership Survey on Operative Laparoscopy had a response rate of 24%. A total of 880 respondents reported performing 36928 operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer operative laparoscopy procedures. A total of 75% of the respondents reported performing 47 or fewer procedures. The most frequently conditions managed by operative laparoscopy were endometrial implants, extensive adhesions, and ovarian cysts. Most operative laparoscopies were performed because of infertility (40%) or pelvic pain (41%). The overall serious complication rate was 15.4 per 1,000 procedures. Complications which occurred in more than 1 per 1,000 procedures included hospitalization greater than 72 hours, persistent HCG titer elevation after ectopic pregnancy, hospital readmission, and unintended laparotomy to manage bowel injury, urinary tract injury, and hemorrhage. Two deaths (5.4 per 100,000 procedures) were reported.
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PMID:American Association of Gynecologic Laparoscopists 1988 Membership Survey on Operative Laparoscopy. 214 9

Endometriosis is an extremely common gynaecological disease, affecting between 1 and 5% of women of reproductive age. Women with endometriosis typically present for medical care with one of more of the following problems: pelvic pain, infertility, or a large adnexal mass (an endometrioma). The primary treatment for an endometrioma is surgical. However, long term postoperative hormone therapy may be necessary to prevent new endometriomas from developing. There is no evidence that hormonal therapy of endometriosis will improve fecundability in women with endometriosis and infertility. Pelvic pain due to endometriosis can be successfully treated with hormonal agents in the majority of patients. Four basic hormonal regimens are currently available for the treatment of endometriosis: (a) danazol; (b) gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH); gonadorelin] agonists; (c) progesterones (progestins); and (d) combined estrogens and progesterones. Randomised, controlled, clinical trials suggest that danazol and the GnRH agonists are equally effective in the treatment of endometriosis. However, the side effects caused by danazol and the GnRH agonists are markedly different. Danazol produces androgenic side effects including weight gain, hirsutism, acne, oily skin and deepening of the voice. GnRH agonists produce side effects due to hypoestrogenism, including hot flushes, osteoporosis and dry vagina. The ideal drug regimen for the treatment of endometriosis remains to be developed.
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PMID:Endometriosis 1990. Current treatment approaches. 219 Jul 93

Prolonged intrauterine retention of fetal bone parts is a rare complication of induced abortion, spontaneous intrauterine fetal death, and missed abortion. Here, a case of long-term retention of fetal bone fragments in a 47-year-old Italian women who underwent elective abortion 8 years earlier is reported. The patient was admitted for acute pelvic pain with purulent vaginal discharge. She reported recurrent episodes of abdominal and pelvic pain, meteorism, dysuria, nausea and vomiting, headaches, and irregular cycles with dysmenorrhea and inter menstrual bleeding since the 1979 abortion. Initially, pelvic inflammatory disease was diagnosed and antiphlogistic drugs were prescribed. When symptoms persisted after 10 days of drug treatment, the patient underwent a laparotomy that revealed pyosalpinx with extensive pelvic adhesions. Total hysterectomy with bilateral adnexectomy was performed. The uterine cavity was found to be closely packed with fragments that were determined at stereomicroscopic examination to be pieces of fetal bone. Of particular concern is the potential of this complication to lead to secondary infertility. The retained bone fragments can function similarly to an IUD by producing an increase in the local insertion of prostaglandins and preventing blastocyst implantation. Moreover, the retained fragments are an ideal substrate for bacterial colonization, which can spread to the tubes and destroy the functional integrity of the reproductive apparatus. Retention of fetal bones should thus be considered as a possible etiologic factor in cases of infertility of women with a history of abortion.
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PMID:Prolonged retention of fetal bones: intrauterine device and extrauterine disease. 236 50

The neodymium:yttrium-aluminum garnet (Nd:YAG) laser was used via laparoscopy in 84 patients complaining of infertility and/or pelvic pain. All patients in the study had biopsy-proven or visually confirmed pelvic endometriosis. The Nd:YAG laser was used in conjunction with sapphire probes as a touch technique on tissue. Problems usually encountered, such as mirror alignment, beam focus, and smoke plume, with carbon dioxide laser systems were avoided, and use of the laser in a liquid environment was possible. Restoration of fertility was seen in 39.7% with short follow-up; pain relief was excellent, especially in conjunction with uterosacral denervation.
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PMID:Treatment of endometriosis with a Nd:YAG tissue-contact laser probe via laparoscopy. 247 10

The first hundred laparoscopies carried out in the "Hospital Parroquial de San Bernardo", between november 1986 and june 1988; were evaluated. The indications for the procedure were: 38% study of infertility, in which a 78% of tubal obstruction or adherencial syndrome was demonstrated; 37% because of ectopic pregnancy, with a diagnostic correlation of 48.6%. The remainder cases were adnexal masses or pelvic pain study. A 42% of the patients had previous pelvic or abdominal surgery. As complications there were two "pre-pneumoperitoneaum", one pelvic inflammatory process and one anesthetic accident, hospitalization time and costs, justifies completely the acquisition of the necessary equipment and technical ability.
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PMID:[Diagnostic and therapeutic laparoscopy in gynecology: analysis of the first 100 cases in the Hospital Parroquial de San Bernardo]. 248 70

The presence of pelvic adhesions is implicated as a significant cause of pelvic pain, bowel obstruction and infertility in women. Laparoscopy has become an invaluable method for the evaluation and treatment of such adhesions. A prospective study was designed to correlate specific findings in the preoperative history and physical examination with the presence of adhesions seen at laparoscopy. Two hundred seventy-three consecutive patients undergoing laparoscopy were analyzed; pelvic adhesions were found in 99 (36.3%). At the time of laparoscopy the only historical predictor found to be associated with adhesive disease was previous pelvic surgery. Physical examination predictors associated with the presence of adhesions were uterine immobility, a right adnexal mass and right adnexal tenderness.
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PMID:Predictors of pelvic adhesions. 252 88

Serum Ca-125 levels were measured in 154 patients undergoing laparoscopy or laparotomy for infertility and/or pelvic pain. Pelvic endometriosis at various stages was observed in 102 of the patients, and 52 had a visually normal pelvis and served as a control group. We found a significantly higher mean serum Ca-125 concentration in the patients with stages III and IV endometriosis compared with the controls (P less than 0.001) whereas in the patients with stages I and II disease the mean antigen level was comparable to that of the control group. Considering its low sensitivity (14.7%) the usefulness of serum Ca-125 measurements as an initial diagnostic test for endometriosis is scanty. On the contrary, because of its elevated specificity (100%), this test may be useful in indicating early surgical exploration of the pelvis in cases of infertility and/or dysmenorrhea which are associated with high values of Ca-125.
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PMID:Serum Ca-125 concentrations in endometriosis. 253 79


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