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

Women experiencing gynecological disorders can suffer from a diversity of symptoms and problems. To what extent women are relieved of their physiologically and psychosocially based symptoms by hysterectomy is an important issue. This study aims to evaluate the long-term impact of hysterectomy on such symptoms and to compare the findings with those of a control group. Women with gynecological disorders experienced physiologically based symptoms, such as pelvic pain and urinary incontinence, to a greater degree than did the control group (p < 0.05), whereas bowel function and menopausal symptoms were equally distributed in the two groups. Furthermore, these women experienced psychosocially based symptoms, such as fatigue and insomnia, to a greater degree than the control group (p < 0.05), whereas the groups did not differ in psychological well-being or sexual function. After hysterectomy, however, pelvic pain and sleeping disturbances were alleviated, and the state of energy and urinary function were improved (p < 0.00). Bowel function, menopausal symptoms, psychological well-being, sexual function, and self-perception as a woman were not influenced by the operation. Both 6 and 12 months after hysterectomy, no differences between the patients and the control group were found, except for the tendency of patients not to gain weight after the operation. The symptoms are mostly improved or unchanged after hysterectomy, and additional problems do not seem to follow the operation.
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PMID:Are the physiologically and psychosocially based symptoms in women suffering from gynecological disorders alleviated by means of hysterectomy? 1155 55

Chronic pelvic pain and vulvodynia are frustrating pelvic disorders seen in young adult women. In the medical literature, these two conditions are linked together under the category of "chronic pelvic pain syndromes." Underlying pathophysiology is not well understood, and relatively scant research is available on successful treatment options. Patients often seek the help of specialists who provide nonsurgical treatments for incontinence and related pelvic disorders. This article provides an overview of the clinical presentation of both chronic pelvic pain and vulvodynia. Specific evaluation techniques, including abdominal, pelvic, bimanual rectal-vaginal, and neurologic examinations, are described. Several practical treatments, such as dietary interventions, vitamin supplementation, muscle relaxation training, biofeedback therapy, and electrical stimulation are discussed as options in a private practice setting.
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PMID:Pelvic disorders in women: chronic pelvic pain and vulvodynia. 1189 Jan 36

To assess the efficacy of a modified technique in stress incontinence, that is vaginal wall sling reinforced with two layers of vaginal wall sutured inferiorly. 27 patients with Type II incontinence, 4 with Type III and 14 with mixed type who completed two years follow up were included into the study. Cure, improvement and failure rates were 84.4%, 8.9% and 6.7% respectively. Temporary retention is observed in 30 of the patients, vaginal stenosis and pelvic pain in 1 and suture granuloma in 5 of the patients. Reinforced insitu vaginal wall sling which gives additional support to urethral hammock inferiorly offers a better solution to both types of stress incontinence.
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PMID:Modified insitu vaginal wall sling in stress incontinence. 1198 56

Voiding disorders are common in urological patients. Pelvic floor dysfunction may result from overtraining pelvic floor muscles in an attempt to prevent leaking. This can further cause bladder dysfunction or weakening the pelvic floor muscles. Pelvic floor dysfunction or insufficient relaxation of the pelvic floor results in hesitancy, intermittency, and high postvoid residuals (PVR). Behavioral changes and biofeedback play a key role in urologic problems including pelvic pain, irritative voiding symptoms, recurrent urinary tract infections, and incontinence. Biofeedback involves using electrodes to transduce muscle potentials into auditory or visual signals; patients learn to increase or decrease voluntary muscle activity. Conservative behavioral and biofeedback treatments are safe and effective interventions that should be more readily available to patients as a first-line treatment for voiding dysfunction. Patient education may take time but has higher long-term success and makes the patient more responsible and less passive regarding their condition.
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PMID:Role of behavioral changes and biofeedback in urology. 1252 86

Retroperitoneal schwannoma is a rare tumor that originates in the neural sheath and accounts for only a small percentage of retroperitoneal tumors. Presentation is typically varied and non-specific ranging from abdominal pain, abdominal mass or an incidental finding and the diagnosis is quite often fortuitous being confirmed by anatomopathological study afterwards. We report 3 cases of benign retroperitoneal pelvic schwannoma with varied presentations. Main symptoms were abdominal and pelvic pain whereas a patient with left parailiac mass had urinary incontinence and left lower extremity pain. Surgical exploration and complete excision of tumors were successful. The histological diagnosis of the tumors was reported as benign schwannoma. All patients are doing well and had no symptoms of motor or sensory disturbances after surgery with a mean follow up of 18 mounts.
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PMID:Retroperitoneal benign schwannoma: report of three cases and analysis of clinico-radiologic findings. 1296 6

Sacral neuromodulation provides a new option for the management of voiding dysfunction. For patients with intractable urge-incontinence, interstitial cystitis and non-obstructive urinary retention, this procedure has resulted in significant improvement in urinary frequency, voided volume and pelvic pain. We provide a review of the current literature on sacral neuromodulation and the West Virginia University experience with this procedure.
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PMID:Genitourinary applications of sacral neuromodulation. 1451 35

Patients with refractory interstitial cystitis (IC) underwent testing with sacral nerve modulation via either a traditional percutaneous approach or a staged procedure. Implanted patients were followed with scaled questionnaires and voiding diaries. Twenty-six patients who had a permanent InterStim placed had a reduction in 24-h voids of 51%. More than two-thirds of patients reported a moderate or marked improvement in urinary frequency, urgency, pelvic pain, pelvic pressure, incontinence and overall quality of life. The test to implant rate of a traditional percutaneous procedure was 52%, compared to a staged procedure of 94%. Assessing sensory response at the time of implant reduced the reoperation rate from 43% to 0%. Ninety-six per cent stated they would undergo an implant again and recommend the therapy to a friend. We concluded that sacral nerve modulation can treat refractory IC symptoms. The response to therapy and the reoperation rate are dependent on the technique used to test and implant the device.
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PMID:Sacral neuromodulation for the treatment of refractory interstitial cystitis: outcomes based on technique. 1453 Aug 31

Hysterectomy may be overused as treatment for abnormal uterine bleeding due to benign causes in reproductive women. Medical therapies are an alternative, and there is a need for randomized trials comparing the outcomes of these approaches. Women of reproductive age who continued to have bothersome abnormal uterine bleeding after cyclic hormonal treatment with medroxyprogesterone acetate (MPA; 10-20 mg for 10-14 days/month) for 3-5 months were invited to participate in a randomized trial of hysterectomy versus other medical therapies. Participating gynecologists were free to choose the particular surgical (transabdominal or transvaginal) or medical (generally oral contraceptives and/or a prostaglandin synthetase inhibitor) approaches. Outcomes during 2 years of follow-up include quality of life (primary), sexual function, clinical effectiveness and cost. We screened 1557 women to find 413 who began 3-5 months of MPA; 215 completed this treatment, of whom 102 still had bothersome symptoms, and of these 38 consented to be randomized. Another 25 women with bothersome symptoms after a documented history of 3 months of cyclic MPA were also randomized, for a total of 63. The average age of randomized women was 41; 54% were African-American, and they reported uterine bleeding 12 days/month on average, heavy bleeding 6 days/month. Anemia (hematocrit<32) was present in 38% of African-Americans and 15% of Caucasians (p=0.05). Two thirds of the women had fibroids and 80% reported pelvic pain. Obesity was common (45% had a body mass index (BMI)>30), and associated with a longer duration of symptoms (12 vs. 4 years for BMI<25; p=0.02) and a greater prevalence of incontinence (44% vs. 16%; p=0.046). Although recruitment was difficult, we have completed enrollment in a randomized clinical trial comparing surgical and medical treatments for abnormal uterine bleeding.
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PMID:Medicine or Surgery (Ms): a randomized clinical trial comparing hysterectomy and medical treatment in premenopausal women with abnormal uterine bleeding. 1498 Jul 55

Criminal statistics say that 300,000 children are sexually abused in the Federal Republic of Germany every year: 70-75% are abused by their own fathers or another psychological parent. Most victims are girls aged 7-12 years. Sexual abuse during childhood can lead to severe psychosomatic dysfunctions both in children and adults. Possible long-term results are depression, anxiety, emotional and cognitive problems, personal dysfunction, eating and sleeping disorders, alcohol or drug abuse, relationship problems, social maladaptation, and somatizations. Many urological dysfunctions without organic findings can be caused by sexual abuse. Among others, chronic pelvic pain (CPPS), enuresis, incontinence, and sexual dysfunction can occur. When children or adults see the urologist because of their symptoms there is always the danger of reproducing the abusive event by invasive diagnostic methods.Sometimes harming themselves the patients bring this situation about unconsciously. With the following article we want to heighten the awareness among urologists.
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PMID:[Urological dysfunction after sexual abuse and violence]. 1504 85

Botulinum toxin is a presynaptic neuromuscular blocking agent inducing selective and reversible muscle weakness for up to several months when injected intramuscularly. In urology, indications for botulinum A toxin injections have been reported in detrusor-sphincter dyssynergia, neurogenic detrusor over activity and benign prostatic hyperplasia. Randomized controlled studies are available for these indications. During the last few years, the indications have been expanded to include chronic retention, chronic pelvic pain, and motor and sensory urinary urge incontinence. However, further research is needed on the efficacy and safety as well as the dilution, dose and number of injection sites.
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PMID:[Botulinum toxin in urology. Indications and results]. 1530 5


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