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

Pelvic tuberculosis (TBC) was diagnosed in 20 patients studied during the years 1971 to 1975. Fourteen patients were born outside the United States. The most frequent presenting complaints were infertility (14 patients), pelvic pain (6), and amenorrhea (4). Only 5 patients gave a history of previous treatment for TBC. Results of pelvic examination were normal in 11 patients; results of chest X-rays were normal in 15. Sixteen patients had endometrial biopsies, 10 of which showed granulomatous endometritis. Fifteen patients had hysterosalpingograms, all of which yielded abnormal results, and 14 were indicative of TBC. Cultures were positive for Mycobacterium tuberculosis in 6 of 16 patients. Genital TBC should be considered as a possible cause of infertility, especially in foreign-born patients. Although a conclusive diagnosis can be made only from a positive culture or histologic specimen, hysterosalpingography is a very useful aid in establishing the diagnosis.
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PMID:Pelvic tuberculosis. 81 84

Pelvic tuberculosis was diagnosed in 72 patients analyzed during the years 1979-1989. Twenty-nine percent of the patients were over 40 years of age. The most common complaints were infertility (47.2%), abdominal or pelvic pain (32%) and abnormal uterine bleeding (11%). Only 2 patients had past or family history of pulmonary tuberculosis. The physical examination was normal in 31.6% of the patients. The chest X-ray was normal in 81% of the patients. Blocked tubes were present in 32 of 34 patients who had hysterosalpingograms. Even if the diagnosis can be made from a histopathologic examination, hysterosalpingography is also a very useful aid in establishing a diagnosis. The most common site of infection was the tubes. Reconstructive surgery was performed in nine patients. Only one pregnancy was found in the present study without any medical or surgical treatment of pelvic tuberculosis. In one patient with habitual abortion as a cause endometrial tuberculosis was also found.
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PMID:Pelvic tuberculosis. 134 99

A case of primary adenocarcinoma and tuberculosis of the Fallopian tube is presented. The clinical symptoms of the patient were pelvic pain and primary infertility. The gynecologic examination revealed a palpable tubal mass and the diagnosis was performed from the laparotomy and the pathology report.
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PMID:Primary adenocarcinoma of the fallopian tube with tuberculosis (short communication). 280 17

The authors report the case of a 14 year-old girl presenting with pulmonary, adrenal and genital tuberculosis. Pelvic pain was the presenting symptom. Association of familial contamination, phlyctenular Mantoux test, apex infiltrate with a calcified nodule on chest x-ray film and numerous pelvic calcifications on plain films of the abdomen led to diagnosis. The authors emphasize the importance of the supervision of Mantoux test and the necessity of treatment of any latent primary tuberculosis.
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PMID:[Genital tuberculosis in a 14-year-old girl]. 359 20

A study has been made of 710 patients with proved gynaecological tuberculosis investigated between January 1, 1951 and March 31, 1985. The main presenting symptoms in order of frequency were infertility, pelvic pain, excessive menstrual loss and amenorrhoea. The average age was 31 years at first attendance, only 16% of married women had been pregnant and palpable adnexal masses were found in 47%. Seven drug programmes have been used, the best results being obtained with the current regimen employing rifampicin, ethambutol and isoniazid. Where drug treatment failed, surgery under further drug cover was successfully employed. Toxic drug reactions occurred in 114 patients.
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PMID:Gynaecological tuberculosis: analysis of a personal series of 710 cases. 386 58

200 cases of pelvic actinomycosis have been recorded so far, including those which are IUD-related. This paper describes a case of Actinomycosis associated with IUD use. The patient was a 46-year old woman (para 3) who was seen complaining of a 2-week old lower abdominal and pelvic pain and a pelvic mass. She had an IUD inserted 10 weeks before but had it removed 2 weeks prior to referral due to pain and bleeding. Degenerating uterine fibroids was the initial diagnosis, and laparotomy was performed. Biopsy of a segment of the Fallopian tube revealed a lesion which clinically resembled an invasive carcinoma but pathological diagnosis revealed actinomycosis. Penicillin therapy (20 million units daily for 6 weeks and 4 g orally/day for 16 weeks) was instituted and the patient recovered uneventfully. Actinomycosis is a subacute or chronic, usually progressive disease, of orofacial, thoracic or abdominal tissues. Development of infection is associated with trauma, teeth extraction, perforation of hallow viscera, and foreign bodies. Initial diagnoses of this disease usually include tuberculosis, chronic staphylococcal infection, and malignant diseases. Treatment of choice is penicillin given in massive doses over a long period of time, 3 to 6 million units daily for 6 months as advocated by Fisher and Harvey (1956). Antibiotics such as aueromycin (McVay et.al., 1951); chloramphenicol (Littman et.al., 1952); isoniazid (McVay and Sprunt, 1953); oxytetracycline (Lane et.al., 1953); lincomycin (Mahr et.al., 1970); and clindamycin (Rose and Rytel, 1972) have also been used successfully in the management of this disease.
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PMID:Pelvic actinomycosis following insertion of an intrauterine contraceptive device. 693 Feb 54

Combined histological and bacteriological investigations of 800 specimens of nonpregnant endometrial curettings of 15 to 60 years age group of hill women of Darjeeling District were carried out for detection of tuberculous endometritis. The principal complaints were infertility (47.5 per cent), abnormal uterine bleeding (30.75 per cent), amenorrhoea (11.25 per cent), leucorrhoea (6.25 per cent), and miscellaneous conditions (pelvic pain and pyometra) (4.25 per cent) cases. By histological examination alone, only 10.9 per cent cases could be diagnosed while by combined study the incidence rate was 11.8 percent, an increase in the diagnostic acumen by more than 10.3 per cent. Bacteriological study was of greater value in doubtful cases where there was absence of tuberculous granuloma or epithelioid cell but presence of nonspecific inflammatory cells along with variable degree of necrosis of glandular epithelia. The incidence of M.tuberculosis was 97.7 percent while that of atypical mycobacteria was 2.3 per cent. Thus simultaneous use of culture and biopsy yielded better results. Our prevalence is a little higher than other reports from India. In cold weather at a high altitude, the tubercle bacilli survive longer in fomites which serve as important sources of infection in Darjeeling. Women of third decade are more frequently affected (43.2 per cent).
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PMID:Tuberculous endometritis in hills of Darjeeling: a clinicopathological and bacteriological study. 815 2

Female genital tuberculosis is not uncommon in countries where pulmonary tuberculosis is widespread. Improved diagnostic techniques (e.g., endometrial curettage and biopsy, histologic examination of curettage, hysterosalpingography, bacteriologic examination of menstrual blood, laparoscopy, and ultrasonography) have resulted in increased awareness of genital tuberculosis. Another trend has been heightened awareness of the potential role of female genital tuberculosis in infertility; this infection has been implicated in 5-10% of infertility cases. Genital organs most frequently affected include fallopian tubes (95-100%), endometrium (50-60%), and ovaries (20-30%). In 92% of cases, genital tuberculosis is secondary to a focus in the lungs, lymph nodes, urinary tract, bones, or joints. Given the hormone-dependent nature of female genital tuberculosis, 90% of cases involve women under 40 years of age. The major presenting symptoms are infertility (45-55%), pelvic pain (50%), poor general health (25%), and menstrual disturbances (20%). The differential diagnosis includes chronic pelvic inflammation, mycotic infection, enterobiasis, lipid salpingitis, and carcinoma. Female genital tuberculosis is treated with the same long-term, combined drug therapy used in pulmonary and extrapulmonary tuberculosis. Surgery should be undertaken only after continuous drug treatment of 12-18 months' duration. In women of childbearing age, an attempt can be made to preserve one ovary. Successful pregnancy is unlikely, however, after complete antituberculosis treatment or tuboplastic surgery.
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PMID:Overview of tuberculosis of the female genital tract. 901 82

Infertility affects 10-15% of all couples. Pelvic infections are an important cause of infertility, primarily as a result of tubal damage. Damage to the fallopian tubes from infections may be due to adhesions, tubal mucosal damage, or tubal occlusion that interferes with normal ovum transport. The infections most commonly related to infertility include gonorrhea, chlamydia, and pelvic inflammatory disease. Tuberculosis also is a common cause of infertility in Third World nations. Sequelae resulting from these infections include ectopic pregnancy, infertility, chronic pelvic pain, hydrosalpinx, and tuboovarian abscess. Neisseria gonorrhoeae and Chlamydia trachomatis are the primary causes of pelvic inflammatory disease. Chlamydial infections may be asymptomatic, and the resulting salpingitis is often referred to as silent pelvic inflammatory disease. Polymicrobial infection with other organisms such as anaerobes or facultative aerobes may be initiated by gonorrhea, chlamydia, or both. Early recognition of infection, prompt institution of appropriate antibiotic therapy, and proper follow-up are important to prevent the sequelae of pelvic inflammatory disease. Surgical intervention may be needed to treat immediate or long-term sequelae of infection. Prevention of pelvic infections should be a high priority. Fortunately, treatment options such as tubal microsurgery and assisted reproductive technologies offer couples reproductive options even when infertility occurs as the result of a previous pelvic infection.
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PMID:Infections and infertility. 1102 72

Female genital tuberculosis is a symptomless disease inadvertently uncovered during investigation for infertility. The condition is relatively rare and often arises secondary to a primary focus elsewhere. The fallopian tube is the organ most commonly affected. Symptomatic disease usually presents with infertility, pelvic pain or menstrual irregularities. Diagnosis is daunting, even where grounds for suspicion exist. Molecular-based diagnostic methods are likely to play a prominent role in the future. Drug treatment is similar to that of pulmonary tuberculosis, although criteria for assessing the effectiveness of therapy are lacking. Return to fertility after treatment is not encouraging. In-vitro fertilization with embryo transfer remains the most effective method of treating associated infertility. Clinicians need to be aware of the existence of this important cause of infertility in women, in view of the continuing HIV epidemic and the current upsurge in tuberculosis worldwide, as well as the continuing migration of large numbers of women and their families out of areas where tuberculosis is endemic.
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PMID:Female genital tuberculosis: a global review. 1530 14


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