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

Twenty-five women with chronic pelvic pain who had undergone diagnostic laparoscopy and 30 women who had laparoscopic examinations for tubal sterilization or infertility investigation were compared psychologically using structured psychiatric and sexual abuse interviews. Results of the fiberoptic pelvic examination were rated independently using the American Fertility Society classification of endometriosis. Compared with controls, the patients with chronic pelvic pain showed significantly greater prevalence of lifetime major depression, current major depression, lifetime substance abuse, adult sexual dysfunction, and somatization. They were also significantly more likely than controls to have been a victim of childhood and adult sexual abuse. There were no significant differences in either the degree or type of pelvic disease between patients with pelvic pain and controls.
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PMID:The association between chronic pelvic pain, psychiatric diagnoses, and childhood sexual abuse. 296 26

In order to evaluate the efficiency of Danazol treatment on pelvic endometriosis, a laparoscopic control with photographs was performed before treatment in 33 cases. Of these 20 were severe (group A), seven mild (group B) and six light (group C), according to the American Fertility Society classification, and 15 patients were infertile, 10 had pelvic pain and eight had dysmenorrhoea. Among the 28 patients who accepted a laparoscopic control after 6 months of treatment, the result was quite good in 50% of the cases in groups B and C, an improvement was seen in 30% of the patients in groups A and B, but a failure in 50% of the cases, especially in group A. Of the 14 cases with an ovarian cyst greater than 3 cm in diameter an operation was necessary either by laparoscopy (four cases) or by laparotomy (five cases). Seven pregnancies were established out of 15 cases of infertility, but a relapse was noticed in 30% of the cases. In conclusion, it appears that Danazol therapy is effective in mild or light endometriosis, but is not sufficient in cases of ovarian endometriosis with cysts greater than 3 cm in diameter.
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PMID:Laparoscopic control of danazol therapy on pelvic endometriosis. 296 11

Seventy-five patients, from December 1984 to December 1985, received carbon dioxide (CO(2)) laser laparoscopy for infertility and pelvic pain. The chief complaint of 55 patients was pelvic pain, and for 20 patients, either primary or secondary infertility. The most common findings were endometriosis (84 percent) and pelvic adhesions (35 percent).This paper gives the incidence of multiple diagnostic findings and the use of CO(2) laser laparoscopy. The results indicate that with the availability of the CO(2) laser laparoscope a significant number of patients can be treated for endometriosis, pelvic adhesions, salpingitis, and other disorders, preventing the need for future surgical procedures or medical therapy.
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PMID:Carbon dioxide laser laparoscopy in treatment of infertility and disorders associated with pelvic pain. 297 89

Five cases of intestinal endometriosis presented with infertility and pelvic pain. Rectal bleeding occurred in two patients and diarrhea in one. A diagnosis was achieved with a barium enema study and colonoscopy. All the patients had pelvic endometriosis as documented by laparoscopy. Endometriosis was present in the sigmoid colon in three patients and in the cecum in one; it was pericecal in the fifth. Bowel resection and pathologic study are necessary to relieve the symptoms and avoid neglecting a malignant tumor or other lesions.
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PMID:Diagnosis and management of intestinal endometriosis. A report of five cases. 319 19

An analysis of published studies of the effect of antibiotic prophylaxis associated with vacuum aspiration abortion includes an examination of risk factors for pelvic inflammatory disease (PID), cervical and vaginal flora present in early pregnancy and in PID, the effect of surgical scrub and of prophylaxis on flora, principles of antibiotic prophylaxis, and economic costs of PID. From several prospective studies, it is clear that nulliparas, women with a history of PID, those bearing Chlamydia trachomatis are at risk of post-abortion infection. No risk was associated with pelvic pain, dysmenorrhea, social class, insertion of an IUD, or timing of resumption of coitus. After an extensive enumeration of microbes found in nonpregnant, pregnant, and PID female genital tracts, it was concluded that only C. trachomatis and N. gonorrheae are clearly associated with PID, while the importance of several other microbes is unclear. Quantitative counts of organisms in any condition are lacking. PID is polymicrobial; different organisms probably account for noniatrogenic PID and post-surgical PID. There is evidence that surgical cleansing of the vagina has no bearing on incidence of post-abortal PID, since the responsible organisms come from the endocervix. 5 controlled clinical trials demonstrated that antibiotic prophylaxis is warranted; that penicillin/ampicillin selectively reduced PID in women with PID history; that imidazoles preferentially reduce PID in the general population without PID history. No lasting side effects or emergence of resistant organisms was reported. The treatment was cost effective, cutting health costs and labor losses 5-8%, and reducing the incidence of spontaneous abortion, secondary infertility, and chronic pain.
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PMID:Pelvic inflammatory disease following induced first-trimester abortion. Risk groups, prophylaxis and sequelae. 327 98

Chlamydia trachomatis infection is the most prevalent sexually transmitted disease in developed countries today. It produces a number of oculogenital syndromes in adults as well as conjunctivitis and pneumonitis in infants. However, the most important sequelae are infertility, ectopic pregnancy, and chronic pelvic pain in women. Available diagnostic tests including culture are less than 100% sensitive but may be of considerable value in detecting asymptomatically infected individuals. Antichlamydial therapy is usually effective and should be given empirically to individuals whose presentation places them at high risk for infection.
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PMID:Chlamydial infections. 328 82

The recent heightened interest in endometriosis has led to remarkable progress in the elucidation of the pathophysiology of this enigmatic disease. Presently, it is not clear why some individuals with endometriosis develop infertility and pelvic pain, whereas others with a similar degree of disease do not. Several tantalizing clues have been extracted from studies of the molecular pathogenesis, immunology, and biochemistry of endometriosis. Investigations are now under way to determine the specific relevance to infertility of macrophage aggregation; prostaglandin and related metabolite production by endometriotic lesions and macrophages; specific factors released by endometriosis that might directly impair ovum pick-up, fertilization, embryo transfer, or implantation; and ovulatory dysfunction including luteal phase deficiency and LUFS. There are probably a host of potential mechanisms of infertility in endometriosis; additional research should enable us to determine their regulatory features and to formulate effective clinical intervention. We now have a broader array of options for the treatment of endometriosis than ever before. However, most of the extant reported clinical experience consists of case reports and limited series of patients without the use of controls, follow-up intervals, and appropriate statistical analysis. The diverse course and presentation of the disease have limited our ability to develop a staging system that provides consistent scoring among different clinicians and appropriate relative emphasis on the various manifestations of the disease. Some additional resolution will be necessary to assess the relative contribution to infertility by fresh and recurrent lesions, endometriomas, and adhesions. These problems are now in sharp focus, and data should be available in the future giving us an accurate appraisal of the clinical effectiveness of danazol, gestrinone, GnRH analogues, conservative surgery, laparoscopic surgery including use of the laser, IVF-ET, and GIFT. Also, it is anticipated that potentially fertile patients with endometriosis might be identified so that they could avoid therapy altogether.
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PMID:Pelvic endometriosis. 332 33

The diagnosis and management of heterotopic intrauterine bone formation was performed hysteroscopically in nine patients. The presenting symptom was secondary infertility in seven, pelvic pain in one and passage of bone fragments in one. All nine patients had a history of spontaneous and therapeutic abortion. Hysteroscopy was more accurate than hysterosalpingography in detecting the condition. Four pregnancies occurred in the seven infertile patients following removal of the bone. In four of nine cases there was clear evidence of remaining bone fragments after the initial removal.
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PMID:Hysteroscopic detection of heterotopic intrauterine bone formation. 336 32

Consultant genitourinary physicians were asked about facilities for chlamydial diagnosis and their perception of the need for this service. A wide range of facilities was available, but eight respondents had no access to a chlamydial diagnostic service (CDS). Epidemiological treatment was widely practised as a substitute for chlamydial diagnosis; some clinicians used a CDS as an adjunct to epidemiological treatment, but few clinicians based their treatment of female contacts of men with non-gonococcal urethritis on the results of a test for chlamydial infection. All respondents felt that a CDS was essential in some situations, although there was a difference of opinion about the extent of the CDS. Most clinicians believed that all or most women should be tested, but the need for testing men routinely was more controversial. Although a CDS is costly, many clinicians believed that early diagnosis was a cost effective procedure if it prevented the long term sequelae of pelvic inflammatory disease--ectopic pregnancy, chronic pelvic pain, and probably infertility.
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PMID:Chlamydial diagnostic services in the United Kingdom and Eire: current facilities and perceived needs. Royal College of Physicians Committee on Genitourinary Medicine. 342 93

A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances).
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PMID:Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics. 352 43


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