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

Peritoneal fluid (PF) lines the abdomen and pelvis and is believed to contain growth factors that stimulate endometriosis, a benign gynecological condition associated with pelvic pain and infertility, in which endometrial cells proliferate and differentiate on the pelvic peritoneum, outside of their normal location within the uterus. In this study, we examined the insulin-like growth factor (IGF) system in seven paired samples of PF and serum from normally cycling women and examined the mitogenic potential of this fluid on cultured endometrial stromal cells. IGF-I, IGF-II, and IGF-binding protein-1 (IGFBP-1), -2, -3, and -4 were identified in PF by immunoassays. PF IGF levels, determined by RIA, were approximately 60% of paired serum levels, and PF levels of IGFBP-2 and IGFBP-3, determined by Western ligand blotting and RIA, respectively, were approximately half of their serum concentrations. IGFBP-4 was barely detectable by Western ligand blotting in PF, and levels of IGFBP-1, determined by immunoassay, were not appreciably different in PF and serum. Incubation of [125I]IGF-II with serum and PF and subsequent size-exclusion chromatography at neutral pH revealed approximately equal incorporation of radiolabel in the IGFBP regions of 150 and 44 kilodaltons (kDa) in serum and primarily in the 44-kDa region in PF. RIA of IGFBP-3 in the IGFBP regions of column effluent revealed that the majority of IGFBP-3 was in the 150-kDa region in both serum and PF, suggesting the presence of the ternary complex in PF. Western ligand blotting of column effluent samples revealed 37-/43-kDa IGFBP-3 primarily in the 150-kDa complex in serum and a marked reduction in the amount of the 37-/43-kDa IGFBP in PF. Western immunoblotting of column effluent with IGFBP-3 antiserum revealed immunoreactive IGFBP-3 forms of 37-43 kDa (major) and 28 kDa (minor) in serum and almost exclusively the 28-kDa band in PF, suggesting that IGFBP-3 in PF may be proteolytically processed. The presence of an IGFBP-3 protease was confirmed using [125I]IGFBP-3 as substrate and was not appreciably present in paired serum samples. Inhibitor profiles demonstrated that this protease is a metal-independent serine protease, and its approximate relative molecular mass was estimated to be 69 kDa, determined by size-exclusion chromatography. The mitogenic potential of IGF peptides and PF was assessed on cultured endometrial stromal cells to test the hypothesis that IGFs in PF may stimulate the growth of endometrium in the pelvic cavity, for example in the disorder of endometriosis.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The insulin-like growth factor system in human peritoneal fluid: its effects on endometrial stromal cells and its potential relevance to endometriosis. 752 31

Uterine leiomyomata are the most common tumors in women and can cause abnormal uterine bleeding, pelvic pain, and infertility. Approximately 200,000 hysterectomies are performed annually in the U.S. to relieve patients of the medical sequelae of these benign neoplasms. Our efforts have focused on cloning the t(12;14)(q14-q15;q23-q24) breakpoint in uterine leiomyoma to further our understanding of the biology of these tumors. Thirty-nine YACs and six cosmids mapping to 12q14-q15 have been mapped by fluorescence in situ hybridization to tumor metaphase chromosomes containing a t(12;14). One YAC spanned the translocation breakpoint and was mapped to tumor metaphases from a pulmonary chondroid hamartoma containing a t(12;14)(q14-q15;q23-q24) and a lipoma containing a t(12;15)(q15;q24); this YAC also spanned the breakpoint in these two tumors, suggesting that the same gene on chromosome 12 may be involved in the pathobiology of these distinct benign neoplasms.
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PMID:Identification of a YAC spanning the translocation breakpoints in uterine leiomyomata, pulmonary chondroid hamartoma, and lipoma: physical mapping of the 12q14-q15 breakpoint region in uterine leiomyomata. 760 52

In this study we present 41 cases of endoscopy surgery in gynecology done in Saint Charles Hospital for: extra-uterine pregnancies (GEU), pelvic abscess, pelvic endometriosis, ovarian cysts (KO), polycystic ovaries (PKO), primary amenorrhea, postoperative pelvic adhesions, uterine fibroma and appendicitis. These patients consulted for infertility, irregular menses and pelvic pain. The procedures done were the following: salpingectomy, endo-tubal aspiration, pelvic abscess drainage and IUD removal, endometrial implants coagulations, excision of ovarian cysts, multiple ovarian punctures (MPO), wedge resection of ovaries, ovarian biopsies, adhesiolysis, myomectomies, hysterectomies and appendectomies. The final results and smooth post-operative course are in favour of the technical and therapeutic advantages of the endoscopic surgery in gynecology as a conservative, functional and preventive procedure.
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PMID:[Gynecologic endoscopic surgery at Saint-Charles Hospital. Review of the literature]. 762 32

Serum CA 125 concentrations are elevated in some women with endometriosis; however, the low sensitivity and specificity of the assay have made it impractical to use it as a diagnostic test for endometriosis. Recently a second-generation CA 125 assay has been developed. The purpose of this study was to compare serum CA 125 concentrations in women with and without endometriosis using both the older assay and the new CA 125 assay and to determine if the new assay concentration improves the clinical utility of CA 125 in the diagnosis of endometriosis. A total of 123 patients with endometriosis, pelvic pain or infertility were enrolled. Blood for CA 125 was drawn in the cycle preceding laparoscopy or laparotomy, and concentrations found by the older and newer assays were correlated with the patients' endometriosis stage using the revised American Fertility Society classification of endometriosis. The CA 125 concentrations determined by the new assay were highly correlated with concentrations determined by the older assay in patients with and without endometriosis (r = 0.96). The sensitivity and specificity were slightly improved using the new CA 125 assay; however, this assay did not dramatically improve detection of endometriosis.
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PMID:Use of a new CA 125 assay in the diagnosis of endometriosis. 765 Jan 45

Endometriosis is a common cause of pelvic pain and infertility in young women. Transvaginal sonography is major means for diagnosing ovarian In our study, we scanned 60 patients with endometriomata who underwent laparotomy or laparoscopy. We compared preoperative ultrasonographic diagnosis with histological reports. The sonographic criteria for the diagnosis of endometriomata were (1) cystic structure with low, homogeneous echogenicity and (2) thick cystic wall with regular margins. In 50 patients, sonography suggested an endometrioma. In 47 cases, the diagnosis was correct. The false-positive cases were all caused by cystic teratomas with a homogeneous sonographic pattern. Ten false-negative cases were diagnosed by ultra-sonography as functional ovarian cysts (5), teratomas (3), and benign ovarian cystoma (1). Only 1 case of a 5-mm endometrioma was demonstrated by laparoscopy but not by TVS. The sensitivity of TVS for diagnosing endometriomata was 82.4% and specificity 97.7%; the positive and negative predictive values were 94% and 92.8%, respectively. The diagnostic accuracy of TVS was 93%. In our experience, TVS is a very specific means for diagnosing endometriomata when the typical pattern is detected; however, the sensitivity of the technique needs to be improved.
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PMID:Role of transvaginal sonography in the detection of endometriomata. 872 24

Schistosoma mansoni is the only cause of bilharziasis in Guadeloupe (French West Indies). Ectopic ovarian and endometrial involvement is rare with only one case of bilharziasis of the endometrium having previously been described in the literature. This report describes two cases of Schistosoma mansoni bilharziasis revealed by genital tract involvement. In one case involvement was endometrial and led to metrorrhagia. Histological examination of the biopsy sample obtained by curettage of the endometrium demonstrated the presence of eggs with lateral spurs. In the other case ovarian involvement was detected during assessment for associated infertility and chronic pelvic pain. Celioscopic examination showed pelvic and perihepatic adhesions secondary to sexually transmissible infection. Histologic examination of an ovarian growth demonstrated the presence of Bilharzia eggs. Both patients underwent antiparasitic treatment using oxamniquine (Vansil) which led to the resolution of metrorrhagia in the first case.
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PMID:[Genital Schistosoma mansoni bilharziasis in women: apropos of 2 cases in Guadeloupe]. 774 28

Infection with Chlamydia trachomatis can be either symptomatic or asymptomatic. In adults, complications include infertility, chronic pelvic pain and ectopic pregnancy. Complications in newborns include conjunctivitis and pneumonia. Screening of asymptomatic women at high risk for the disease can identify candidates for antibiotic therapy. Until recently, chlamydia cell culture was the only diagnostic test and it was not widely available. Because the specificity of cell culture is 100 percent, it remains the standard against which other tests are measured. The recent development of nonculture tests makes it feasible for most laboratories and physicians' offices to offer testing. The main disadvantage of nonculture tests is low specificity. A positive screening test in a woman at low risk should be confirmed by a second test. Routine screening and treatment of patients who are at high risk can decrease the incidence, complications and transmission of chlamydial infection.
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PMID:Screening for Chlamydia trachomatis infection. 760 79

Endometriosis is a disease of the female pelvic mesenchyme in which tissue with epithelial and stromal characteristics of the endometrium develops in a situation other than in the uterus. The aim of this study was to evaluate the prevalence of endometriosis in premenopausal women submitted to laparoscopy and/or laparotomy for infertility, chronic pelvic pain, benign ovarian cysts and uterine myomas. The prevalence of the disease was higher in patients with infertility (30.5%), chronic pelvic (45%) and benign ovarian cysts (43%) than in patients with uterine mvomas (8.5%).
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PMID:The prevalence of endometriosis in premenopausal women undergoing gynecological surgery. 792 3

Endometriosis is a disease observed in women in fertile age, it causes pelvic pain characterized by dysmenorrea and dyspareunia. Moreover, there is an association with infertility. Between the alternative of the medical therapeutics of endometriosis drugs with hipogonadotrofic and hypoestrogenic effects, as the danazol and gestrinona has been used. At present, there are analogies of GnRH factor where leuprolide acetate allow a continue liberation in a monthly administration. This is a case of a woman with extensive endometriosis that has hepatitis due to danazol and subsequently was treated with leuprolide acetate. The effectiveness of leuprolide acetate is analyzed in relation with the relief of pain and the laparoscopic evaluation of the endometriosis focus.
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PMID:[Advanced endometriosis treatment with leuprolide acetate]. 799 63

Deep endometriosis has been defined as endometriosis infiltrating deeper than 5 mm under the peritoneum. A model for the development and propagation of endometriosis is presented. Subtle and non-pigmented lesions are suggested to occur intermittently in all women. Infiltration occurs generally to a few millimeters of depth only, and these lesions become typical, burnt out lesions. In some 20% of women, severe endometriosis develops either as deeply infiltrating disease or as cystic ovarian disease. Arguments are given to consider deep endometriosis and cystic ovarian endometriosis as two specific entities of endometriotic disease. A possible causal relationship with dioxin pollution is discussed. Diagnosis of deep endometriosis is made by clinical examination and palpation during surgery. Clinical examination during menstruation and CA-125 concentrations in plasma are useful to help in the diagnosis of smaller deep lesions. Surgical excision can be carried out by laparoscopy, laparotomy or vaginally using sharp dissection, electrosurgery or with the use of a CO2 laser. Excision is the treatment of choice because of a high pregnancy rate, a complete cure of pain in most women, and a low recurrence rate. Medical treatment is probably less effective to treat infertility, but highly effective in relieving pelvic pain. Medical therapy, by luteinizing hormone-releasing hormone agonists, danazol, or gestrinone, also seems useful as a pretreatment for surgery. The choice of treatment will therefore depend on the local expertise with minimal invasive surgery, certainly if a first excision has been incomplete and pain symptoms recur.
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PMID:Treatment of deeply infiltrating endometriosis. 803 9


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