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

2 case reports involving the use of steroid hormones in the treatment of pelvic infections are presented. The first was a young woman with bilateral salpingo-oophoritis. The patient continued to have low abdominal and pelvic pain and to remain febrile following closure of the posterior cul-de-sac and antibiotic therapy. 2 days after cortisone was added to the treatment the patient was afebrile and after 5 days she was discharged and received diminishing doses of corticosteroid. The second case involved a young married woman with acute salpingo-oophoritis who suffered recurring episodes of salpingitis and urinary tract infection and continued to have disabling abdominal pain, especially with her menses. The infection was treated with sulfasoxisole, and menstruation was suppressed with medroxyprogesterone for 1 year. At the time of writing she had been menstruating regularly for 8 months and was free of abdominopelvic pain.
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PMID:Two unusual uses of steroid hoones in pelvic infections. 579 36

The prevalence rate of vaginal colonization with E. coli was studied prospectively over the January-April 1982 period among 495 healthy premenopausal women, and factors associated with vaginal carriage of E. coli were examined. The study was conducted at the University of British Columbia Student Health Service. A confidential questionnaire was administered for information regarding present sexual activity, methods of contraception, menstrual hygiene, previous history of genital and urinary tract infections, and recent antibiotic use. A manual pelvic examination was performed and vaginal culture was obtained. 28% of the women were seen in the Clinic because of genital symptoms including vaginal discharge with or without irritation, abnormal menstruation, or pelvic pain. 71% of the women attended the Clinic for an annual physical examination and had no genital complaints. E. coli was isolated in 61 women (12%). Other Enterobactericeae were cultured from 6 additional women. Factors significantly associated with vaginal colonization of E. coli included phase of the menstrual cycle, prior use of antibiotics, previous history of urinary tract infection, concurrent presence of gential complaints, and use of diaphragm or cervical cap contraceptive method. Difference in prevalence rates of vaginal E. coli in women using diaphragm or cervical cap compared to rates among women using other contraceptive methods remained statistically significant when other confounding factors such as phase of menstrual cycle, presence of genital complaints, previous history of urinary tract infection, or prior use of antibiotics were kept constant. No significant correlation with vaginal E. coli was observed regarding prior vaginal infection within 2 weeks, sexual activity, intercourse during menstruation, or use of vaginal douche or spray.
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PMID:Vaginal colonization of Escherichia coli and its relation to contraceptive methods. 634 27

Chlamydia trachomatis was isolated from 30 to 100 women attending a family physician's office with dysuria, frequency or vaginal discharge, compared with 2 of 30 asymptomatic women. Multiple infections were common: C. trachomatis coexisted with Gardnerella vaginalis, Candida albicans, Trichomonas vaginalis or a bacterial cause of urinary tract infection in 15 patients. C. trachomatis was isolated alone from 15 symptomatic women. The source of the positive culture was not always the site of symptoms. C. trachomatis was isolated from both the cervix and the urine of 9 patients, either simultaneously or sequentially. The probability of finding a chlamydial infection was 30% in young women with vaginal discharge alone, 33% in those with dysuria and frequency alone and 53% in those with abdominal or pelvic pain in addition to lower urogenital tract symptoms.
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PMID:Chlamydia trachomatis infections in women with urogenital symptoms. 713 48

Prostatodynia is a clinical entity associated with voiding symptoms and pelvic pain suggestive of prostatitis but with a normal prostate examination and without evidence of inflammation or infection in expressed prostatic secretions. The problem tends to be chronic and is vexing in its management. Although thought to be a common condition, prevalence data are generally lacking. From June to October 1995, the U.S. Army's 86th Combat Support Hospital provided medical support to a multinational United Nations peacekeeping force in Haiti. Patients diagnosed with prostatodynia were more common (13 cases) than men with other urologic problems (urolithiasis, 6 cases; urinary tract infection, 6 cases; scrotal abscess/mass, 2 cases; epididymitis, 1 case). Patients tended to be young (mean age 29.8), had multiple visits, failed to respond to multiple courses of antibiotics for presumed "prostatitis," and denied recent sexual relations. Some patients reported having had similar symptoms on prolonged separation from their spouses in the past that resolved with resumption of normal intercourse. Masturbation, however, had no impact on symptoms and was painful in some individuals. Terazosin, an alpha-antagonist, and stress-reduction therapy led to improvement in some patients' symptoms. A discussion of these retrospective findings in light of what is known about the possible etiologies and treatment of prostatodynia is presented. Prostatodynia appears to be a common problem in deployed troops and can lead to frequent use of medical services. Physicians supporting long deployments need to be aware of this entity.
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PMID:Prostatodynia in United Nations peacekeeping forces in Haiti. 918 57

The outcome of abdominal hysterectomy for pelvic pain in premenopausal women was studied retrospectively in 228 women. In 17 women, pelvic pain was the sole indication while in the others, pelvic pain was one of the contributory indications for hysterectomy. The most common surgical histopathological diagnoses were uterine leiomyoma (73.9%), uterine adenomyosis (40.4%), benign ovarian cyst (19.3%) and endometriosis (7.9%); 118 (51.8%) patients had single pathology and 48.2% had multiple pathologies. The agreement between operative clinical diagnosis and histopathological diagnosis was 66.1% for leiomyoma, 57.1% for uterine adenomyosis and 30% for endometriosis. The incidence of early postoperative complication was 20.6%, mainly minor morbidities including urinary tract infection (3.9%), wound infection (3.1%) and unexplained fever (6.0%). These complications significantly prolonged the duration of hospital stay from an average of 7 days to 9-17 days. Of 98 patients with pain as the sole or the most predominant indication for hysterectomy, 72% responded to an outcome survey 12 or more months after hysterectomy. Of these, 62 (87%) were satisfied with the operation, 8 were unsure and 1 was dissatisfied; 68 (95.8%) patients reported relief of their symptoms. Relief of symptoms did not correlate with the patient's report of her satisfaction with hysterectomy. Pain in the abdominal wound a year or more after surgery was one of the commonest reasons cited for dissatisfaction with hysterectomy. We conclude that in well-selected cases, hysterectomy is an appropriate and satisfactory treatment for premenopausal women with pelvic pain irrespective of clinical evidence of associated pathology. Effective measures to reduce postoperative complications and wound pain are needed to further improve the outcome of abdominal hysterectomy.
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PMID:Outcome of hysterectomy for pelvic pain in premenopausal women. 952 96

The case histories of women attending the Urogynecology Department at the Royal Women's Hospital and Mercy Hospital for Women were reviewed between 1986 and 1998 to determine the incidence and postoperative morbidity caused by suture injury to the urinary tract following urethral suspension surgery for stress incontinence. In our department 1103 Burch colposuspensions and 61 Stamey urethral suspensions have been performed. Intraoperative cystourethroscopy was performed routinely for the early detection and treatment of urinary tract injury. Intravesical sutures were found by routine intraoperative cystoscopy in 1 Stamey suspension, 1 open Burch colposuspension and 3 laparoscopic Burch colposuspensions. Ureteric suture ligation was diagnosed in 2 women intraoperatively and 1 women postoperatively after laparoscopic Burch colposuspension. Two women presented with late complications from intravesical sutures following open Burch colposuspension. A further 7 women referred with urinary symptoms were found to have intravesical sutures, 2 following Burch colposuspension, 4 following Stamey urethral suspension and 1 following the Marshall-Marchetti-Kranz procedure. Seven of the 9 women diagnosed with intravesical sutures presented with bladder or pelvic pain, frequency or urinary tract infection. Two women had recurrent stress incontinence and were found to have a intravesical suture on routine cystoscopy at the time of stress incontinence surgery. Suture removal, with any accompanying calculus, was achieved cystoscopically with almost immediate resolution of symptoms without loss of urinary control in all cases. Non-absorbable intravesical sutures occurring as a result of suture misplacement or erosion is an infrequent but important complication of stress incontinence surgery, but should be suspected if pain and irritative bladder symptoms or recurrent urinary infection occur postoperatively. Cystourethroscopy performed intra-operatively or postoperatively is essential for early diagnosis and treatment.
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PMID:Suture injury to the urinary tract in urethral suspension procedures for stress incontinence. 1020 62

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.
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PMID:Management of urinary tract infections. 1121 1

Interstitial cystitis (IC) is a chronic disorder of unknown etiology that affects the lower urinary tract of up to 500,000 women and men in the United States. It is characterized by bladder and pelvic pain that varies from moderate discomfort to severe, debilitating pain and related lower urinary tract symptoms including nocturia, diurnal urinary frequency, and urgency. Because the symptoms of IC superficially resemble a urinary tract infection, it is often misdiagnosed and may remain so for months or even years. This article discusses the clinical manifestations of IC, including its differentiation from acute or recurring bacterial cystitis. Options for managing this significant and often debilitating voiding dysfunction are also discussed.
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PMID:Interstitial cystitis: a guide to recognition, evaluation, and management for nurse practitioners. 1190 18

The prevalence of genital actinomyces infection and possible routes of transmission in IUD users were analyzed in a high-risk population of predominantly indigent Mexican-American family planning clients. The Papanicolaou (Pap) smears of 12 (9%) of the 134 IUD users cultured were positive for actinomyces-like organisms. The IUD involved was the Lippes Loop in 7 cases, the Cu 7 in 2 women, the Dalkon Shield in another 2 cases, and the Saf-T-Coil in the final case. The duration of IUD use ranged from 1-10 years, with a mean of 6 years. Oral-genital sexual contact was the sexual preference in 3/4 of the women with actinomyces infection compared with under 2/3 of the general clinic population. Most of the women with actinomyces-like organisms had a concomitant condition, including gastroenteritis, cholecystitis, scabies, schizophrenia, drug abuse, anemia, herpes genitalis, venereal disease, and urinary tract infection. All of these women complained of vaginal discharge with pelvic pain during their initial visits. Eikenella corrodens was recovered in 1 of these cases and had an overall prevalence of 0.17% in the clinic population. Eikenella corrodens is found in the mouth, on dental plaques, and is not yet recognized as a normal inhabitant of the vagina or gastrointestinal tract. Oral-genital contact appears to be the mode of transmission of both actinomyces and Eikenella corrodens.
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PMID:IUDs and actinomyces. 1228 Aug 26

Women seek gynecologic medical attention for 2 main reasons--abnormal bleeding and pelvic pain. Gynecologists are often more comfortable with the diagnosis and management of abnormal bleeding than with the diagnosis and management of pelvic pain. One reason is that chronic pelvic pain can result from a variety of abdominal and pelvic causes, including endometriosis, pelvic inflammatory disease, adhesions and urogenital causes, such as vulvodynia, and from bladder complaints, including overactive bladder, urinary tract infection and interstitial cystitis (IC). The symptoms of IC--chronic pelvic pain with urinary urgency, frequency and nocturia--are all too frequently attributed to these other causes of chronic pelvic pain, in large part because gynecologists rarely consider the bladder as a source of pelvic pain. In addition, IC can masquerade as, and coexist with, other causes of pelvic pain, particularly endometriosis. Early diagnosis and treatment of IC can reduce the occurrence of unnecessary procedures and treatments and can improve the patient's prognosis and quality of life. Bladder-origin pelvic pain should be considered in all women who present with these symptoms.
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PMID:Chronic pain syndromes of gynecologic origin. 1508 61


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