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

From the 1st demonstration in 1937 that progesterone is an effective inhibitor of copulation-induced ovulation to the 1st combination oral contraceptive (OC), Enovid, the risks and hazards of OCs gradually presented and formulations have been changed, mostly reducing the estrogen content, in hopes of minimizing adverse effects. OCs remain the most effective contraceptive although there are many women who do not tolerate them, do not want IUDs, and prefer some method other than mechanical barriers. The author reports on an experiment with 490 women receiving pellets of oral conjugated estrogens in a monthly step-down fashion, reducing the number of pellets every 6 months, from 4 to 3 to 2 to 1 and after that 1 pellet every 6 months. Of these women 4 pregnancies occurred in 1540 women-years with minimal side effects. Another method, the postponement of menses after ovulation has already occurred, has been accomplished with 20-30 mg norethindrone administered daily beginning as late as day 24 of the cycle. The induction of ovulation with an antiestrogen (MER 25) was 1st reported in 1960; this was believed to have great potential as a contraceptive agent, but tests did not confirm this. It was found in 1961 that clomiphene citrate had a luteotropic effect. It has since been used successfully in cases of secondary amenorrhea, dysfunctional uterine bleeding, polycystic ovarian disease, and others. The incidence of successfully induced ovulation varies from 58-90%. Studies have also revealed markedly elevated levels of androgens and particularly testosterone in women with polycystic ovaries in comparison with normal controls. It appears that an inherent capacity for androgen production by the adrenal gland upsets hypothalamic-pituitary ovarian relations, stimulating the growth of follicles, luteinizing the theca and often certain cellular elements in the stroma. Another drug, danazol, is a new synthetic derivative of the 1st orally effective progestogen, ethisterone, and has proven to have an antiendometrial or endometrial-suppressing activity. It has proven effective in relieving the common symptoms of dysmenorrhea, pelvic pain, dyspareunia, mazoplasia, and mastodynia. It is currently used to reduce breast lumpiness.
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PMID:Dwarfs, standing on the shoulders of giants, see further. 716 94

In the absence of a precise definition, the terms "ovarian dystrophy" are often erroneously used. Therefore we propose a more modern terminology which allows to distinguish two types of ovarian follicle pathology: the microfollicular disease results from a follicular arrest of maturation, leading to an accumulation of immature microfollicles in the ovarian cortex. The clinical correlate is anovulation. This disease encompasses two aetiologic entities: polycystic ovarian disease (PCO) and the multifollicular ovaries (MFO), which were previously gathered under the label of "endocrinal ovarian dystrophy"; the macrofollicular disease results from the excessive growth of one or several follicles with or without luteinisation. Its clinical correlate is pelvic pain. It includes three main aetiologies: macropolycystic ovaries, functional cysts and LUF syndrome. These could also be termed "mechanical or local dystrophy". This new classification allows to consider two distinct anatomical entities which represent the whole of functional ovarian pathology.
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PMID:[Polycystic ovaries: an imprecise ultrasonographic definition]. 762 85

Four women with acute pelvic pain clinically suspected to be secondary to ovarian torsion were examined with gray-scale and Doppler ultrasound. All affected ovaries were enlarged (volumes 3.2-34 times the volumes of the ovaries on the unaffected sides). Three ovaries showed no internal flow, and one showed internal arterial flow. Ovary-conserving treatment was attempted in all four cases but the three ovaries which showed no evidence of internal flow eventually required removal. The fourth case, in which arterial flow was present on Doppler examination, was treated only with laparoscopic untwisting of the pedicle and did not require oophorectomy. The results of our study suggest that Doppler findings may distinguish ovaries which are beyond salvage and require removal from those which may be saved by prompt laparoscopic untwisting of the adnexa, but further studies with larger numbers of patients will be necessary.
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PMID:Endovaginal Doppler ultrasound in ovarian torsion: a case series. 771 64

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

Laparoscopy is a useful and safe diagnostic procedure that provides excellent visualization of the pelvic structures and often permits the diagnosis of gynecologic disorders and pelvic surgery without laparotomy. During the period 1994-1996 40 laparoscopies were performed as a diagnostic procedure on adolescents aged between 14-19 years. In 21 cases of primary amenorrhea the laparoscopy showed 12 cases of Rokitanski-Kuster-Hauser syndrome (57.2%), hematocolpos-hematometra 4 (19.0%), polycystic ovarian disease 2 (9.5%), late onset of puberty 2 (9.5%) and gonadal dysgenesis 1 (4.8%). Laparoscopy which was performed in 12 cases of pelvic pain showed 6 with normal genitalia (50%), endometriosis in 2 (16.7%, infection in 2 (16.7%), fibroma in 1 (8.3%) and torsion in 1 (8.3%). Four laparoscopies were performed for ovarian mass; three cystic masses and one case of endometriosis were detected.
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PMID:Adolescent laparoscopy. 947 1

A 26-year-old woman presented with acute onset of right-sided pelvic pain and had a medical history significant for migraine headaches and polycystic ovarian disease. Ultrasonography demonstrated bilateral ovarian tumors, and the patient underwent laparoscopic removal of bilateral cystic teratomas. A literature review focused on similar presentations of teratomas revealed isolated cases of migraines and polycystic ovarian disease associated with teratomas and an increased risk for ovarian torsion. Our patient experienced complete resolution of her acute abdominal pain, as well as her long-standing headaches and hormonal symptoms, after removal of the teratomas.
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PMID:Multisystem manifestations of benign ovarian teratomas. 2480 21