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

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

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

The aim of the paper was the analysis of 1450 laparoscopic procedures performed in the Clinic of Gynecology--IOG PMA in Szczecin in the years from 1974 to 1992. The above number include 320 laparoscopic operations. In the analyzed three five-year periods, the number of laparoscopies increased twofold, while in the years 1989-1992 it constituted 26.8% of all the operative procedures. Indication for laparoscopy in 74.6% of cases was sterility, in 13.38% pelvic pain of undefined etiology, in 7.7% ectopic pregnancy, 1.8% oncologic indications, in 0.5% internal ones, in 0.3% sterilization and others in 1.6%. Among operative laparoscopies electrocoagulation of endometriosis was carried out in 46.6% of cases, resection of intraperitoneal adhesions in 27.5%, in the region of abdominal orifices of oviducts in 7.5%, ectopic pregnancy operations in 7.2%, excision of ovarian cysts in 6.6% as well as extirpation of myomas in 4.7%. At the analyzed period the following complications were disclosed, namely: interstitial lesion in 2 cases, hemorrhage from inferior epigastric artery in 1 and subcutaneous emphysema in 34 cases.
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PMID:[Nineteen years of laparoscopy in the gynecology clinic IPG PAM]. 130 76

The frequency of infection following induced first-trimester abortion is 3-5%. Duration of hospitalization is often five days, and the total costs per abortion were 5,400 Dkr (approximately pounds 500) in Denmark in 1979. Sequelae of postabortal infection are similar to and occur with the same frequency as sequelae to "spontaneous" pelvic inflammatory disease. Thus, secondary infertility was found in 10% of women with postabortal infection, spontaneous abortion in 22%, dyspareunia in 20%, and chronic pelvic pain in 14%. The risk of ectopic pregnancy is probably also increased. Surgical scrub cannot sterilize the endocervix and, as a consequence, abortion is performed in a contaminated field. The presence of pathogenic bacteria, i.e. Chlamydia trachomatis, therefore increases the risk of postoperative infection. The organism is found in approximately 7% of those applying for abortion and the risk of sustaining infection is 20%. Other risk factors are previous pelvic inflammatory disease, vaginal infection, first pregnancy and young age. Prophylactic antibiotics halve the incidence of infection, but by applying prophylaxis to risk groups only, the amount of prescriptions can be reduced. Prophylaxis need only be administered peroperatively, and tetracyclines, metronidazol, and penicillin/pivampicillin have been found to be effective. Women applying for abortion should be examined for C. trachomatis and positive cases treated no later than at the time of the abortion.
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PMID:[Preventive antibiotics in induced first-trimester abortion]. 146 1

Eight consecutive cases of open laparoscopic oophorectomy and salpingo-oophorectomy are reported. A modified technique that requires fewer specialized instruments and includes removal of the intact adnexa is demonstrated. Patients were not included if there was any suspicion of malignancy. Indications for surgery included chronic pelvic pain after hysterectomy (N = 5), endometriosis (N = 1), estrogen receptor-positive metastatic breast carcinoma that had not responded to chemotherapy (N = 1), and tuboovarian ectopic pregnancy (N = 1). No intraoperative or postoperative complications occurred. The average hospital stay was 1.1 days, and patients were released 3-14 days postoperatively. Five of the six patients with chronic pelvic pain had prompt resolution of their symptoms. In one patient who had a unilateral salpingo-oophorectomy, a contralateral procedure was required 3 months later because of continued chronic pelvic pain; her pain subsequently resolved. Laparoscopic salpingo-oophorectomy has the potential to decrease morbidity as compared with laparotomy in appropriately selected cases.
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PMID:Open laparoscopy simplifies instrumentation required for laparoscopic oophorectomy and salpingo-oophorectomy. 182 37

We report the first 32 patients in whom surgical procedures were performed through laparoscopy. We practiced adhrenciolysis, biopsy and fenestration of cystic ovarian lesions, section of uterosacral ligaments as a treatment for pelvic pain, ovaric biopsies in cases of premature ovarian failure, fulguration of endometriotic implants, myomectomy, conservative management of an hemorrhagic corpus luteum, linear salpingostomy and total salpingectomy in ectopic pregnancy. The average operating time was 45 minutes, and the postoperative stay 28 hours. The only complication was active tubal bleeding in an ectopic pregnancy initially approached through linear salpingostomy, that required laparotomy. We describe the utilized technique, discussing the most frequent indications, and also, the basic elements necessary for performing laparoscopy surgery.
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PMID:[Gynecological endoscopic surgery. Surgical approach by laparoscopy]. 184 92

We performed a prospective study to evaluate the reliability of a rapid monoclonal antibody urine pregnancy test with a sensitivity limit of 20 mIU/mL combined with transvaginal ultrasonography in the early diagnosis of ectopic pregnancy in 116 women with subacute pelvic pain and a stable general condition. The diagnosis of tubal pregnancy was confirmed with laparoscopy in 100 of the 103 women with positive sensitive urine pregnancy tests and no intrauterine gestational sac at transvaginal ultrasonography. Laparoscopy revealed a hemorrhagic corpus luteum in four of the eight subjects with negative monoclonal antibody pregnancy tests and no intrauterine gestational sac, an ovarian cyst in three and a normal pelvis in one. Of the five women with a positive pregnancy test and an intrauterine gestational sac, two had a hemorrhagic corpus luteum, two a normal pelvis and one a tubal pregnancy at laparoscopy. The sensitivity of a monoclonal antibody urine pregnancy test and transvaginal ultrasonography combined for the diagnosis of ectopic pregnancy was 99%, and the specificity was 80%, with positive and negative predictive values of 97% and 92%, respectively.
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PMID:Early detection of ectopic pregnancy. Use of a sensitive urine pregnancy test and transvaginal ultrasonography. 194 85

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


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