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

Over a 3-year period, the percentage of geriatric patients with gynecologic problems treated in one Canadian hospital almost doubled. Pelvic pain, uterine bleeding, and voiding problems were the most common symptoms. Concomitant diseases existed in 60% of the patients, with cardiac and pulmonary problems the most frequent. Uterine fibroids and genital cancer were the most common pathologic diagnoses. Hysterectomy was part of the operative procedure in 37 of 50 patients, and these operations required more time and longer postoperative hospitalization than others. Complications developed in 24% of the patients, with cellulitis, phlebitis, and fever seen most often.
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PMID:Geriatric gynecologic problems increasing. 62 54

Leiomyoma of the vagina occurs extremely rarely and may be confused with a variety of benign vaginal tumors. A preoperative diagnosis is seldom made. The author reports a case of leiomyoma found in the anterior vaginal wall beneath the urethra and associated with pelvic pain and urinary symptoms.
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PMID:Vaginal leiomyoma as a cause of pelvic pain and cystitis cystica. 280 27

We describe 16 cases of intravenous leiomyomatosis of the uterus with unusual histologic features. Most of the patients, who ranged in age from 28 to 76 years (median, 42 years), presented with abnormal uterine bleeding or pelvic pain. On pelvic examination, they had an enlarged uterus. Extension of tumor into the broad ligament was noted at operation in six patients; it was documented on pathologic examination in an additional three cases. Gross examination disclosed enlargement of the uterus by solitary or multiple masses; wormlike plugs of tumor within myometrial veins were noted on initial examination in only five cases. Histologic examination in each case revealed proliferations of benign-appearing smooth muscle within myometrial vessels, at least some of which were large veins. The tumors differed from typical intravenous leiomyomatosis (IVL). They were classified as cellular IVL (six cases), epithelioid IVL (four cases), IVL with bizarre nuclei (two cases), intravenous lipoleiomyomatosis (two cases), myxoid IVL (one case), and IVL with an endometrial component (one case). Of 13 patients with follow-up information, 11 are alive with no evidence of disease or have died of unrelated causes at postoperative intervals of 0.5 to 19 years. One patient underwent resection of pelvic recurrent tumor 2 years postoperatively and was alive with no evidence of disease 2 years later. Another patient had pulmonary metastases 9 years postoperatively, but was alive with stable disease after an additional 6 years. This analysis indicates that most of the histologic variants of benign uterine leiomyoma can exhibit the intravascular growth pattern of IVL. These variants of IVL, except for their cellular composition, resemble typical IVL in both their clinical and pathological features. They should be distinguished from other tumors, particularly endometrial stromal sarcoma and leiomyosarcoma, which differ in their behavior and management.
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PMID:Intravenous leiomyomatosis of the uterus. A clinicopathological analysis of 16 cases with unusual histologic features. 320 47

Leiomyoma of the bladder is an unusual cause of persistent bladder or pelvic pain. Traditional modalities may enable the clinical to suspect the diagnosis, which should be confirmed by transurethral biopsy. Except in rare circumstances, the treatment of choice is a suprapubic abdominal approach for removal of the bladder tumor.
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PMID:Bladder leiomyoma: a rare cause of pelvic pain. 407 64

Seventy cases of myomectomy performed over 5 years (1977 to 1982) in the department of Gynecology & Obstetrics of the St Antoine Hospital in Paris are analyzed. During the same period, 465 patients underwent hysterectomy for leiomyoma. A brief review shows that myomectomy is not the best surgical treatment of uterine leiomyoma because of its complications. Hemorrhagy, pelvic pain and infertility remain the principle modes of discovery of uterine leiomyoma in operated patients, whose median age is fairly low. Hysterosalpingography is still the main procedure for the investigation and diagnosis of leiomyoma. However, indications of echotomography have been extended with an increase in the frequency of diagnosis of leiomyoma due to a better semiology. Primary leiomyoma section followed by excision appears preferable to conventional enucleation, which is frequently hemorrhagic and blind. In determining the indications of myomectomy, certain factors must be borne in mind: age, parity, type and insertion of leiomyoma, gynecologic history and psychological status. Good postoperative results explain the recent favor of myomectomy as the conservative surgical treatment of leiomyoma; surgical abstention, however, remains the best decision in most cases.
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PMID:[Myomectomy in nonpregnant women. Indications. Technics. Apropos of 70 cases at the Saint-Antoine's Maternity Hospital]. 631 Jul 59

1 out of 4-5 women develop uterine leiomyomata, the most common solid pelvic tumors in women. This paper assesses the reports of 4714 myomectomies and records of 59 personal cases. Townsend et al. suggested that leiomyomata are unicellular in origin. Estrogen, growth hormone, and progesterone may influence the growth of the tumors. In the performance of myomectomy, the 2 major technical concerns are the minimization of blood loss and the prevention of postoperative adhesions. Although most leiomyomata are asymptomatic and grow slowly, 20-50% of the tumors are estimated to produce symptoms, the severity of which depends upon the number, size, and location of the tumors. The symptoms include menorrhagia, infertility, fetal wastage, pelvic pain/pressure, polycythemia, ascites, impingement, and related complications (e.g., ulceration and infection, fever, pain, uterine inversion, sarcomatous change). Asymptomatic patients with uteri of less than 10-12 weeks' gestational size require no more than observation at 6-month intervals regardless of fertility status. For women with uteri of 10-12 weeks gestational size or longer, management will depend on the patient's desire for fertility. Women desirous of fertility should have a 6-12 month trial for conception. If tumor growth is rapid, myometomy may be performed earlier. Women not desirous of fertility (e.g., pre- and post-menopausal) should have total abdominal hysterectomy and bilateral salpingo-oophorectomy. For symptomatic patients desirous of fertility, myomectomy using the transabdominal approach or hysteroscopy should be performed. For symptomatic patients not desiring fertility, dilatation and curettage and hysterectomy should be performed. With regard to oral contraceptive use, no studies have yet demonstrated that women on oral pills are at increased risk for growth of these tumors. Low-dose contraceptives should not be contraindicated in patients with leiomyomata if they desire to use this form of contraceptive. With IUD users, the device should be discontinued if bleeding occurs.
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PMID:Uterine leiomyomata: etiology, symptomatology, and management. 702 95

6 cases of ovarian pregnancy were reviewed and their relationship with the IUD, fibromyoma of the uterus, and previous spontaneous abortion was examined. 5 of the patients had in situ IUDs, and 1 patient was treated in conjunction with a 20 week size fibroid uterus. 1 of the patients with an IUD also had a fibroid uterus. 4 of the women had spontaneous abortions in their past history. All cases met Spiegelberg's requirements for the diagnosis of ovarian pregnancy. The 6 cases are summarized in table form. During the 4 year period that these 6 patients were treated, a total of 59 ectopic pregnancies were treated at the Hasharon Hospital in Petah-Tikva, Israel. 18 or 30.5% occurred in patients with in situ IUDs. Ovarian pregnancies constituted 10.2% of all the ectopic pregnancies and 20% of the ectopic pregnancies in the group of patients using IUDs. The possibility that the IUD may potentiate ovarian nidation must be considered. It has been suggested that the IUD causes changes in the synthesis of prostaglandins so that tubal peristalsis is increased, and this could increase the incidence of both tubal and ovarian pregnancies. 2 of the patients were initially treated for vaginal bleeding and pelvic pain by removal of their IUDs, and the proper treatment was delayed for 14 days. The ovarian pregnancy in the patient with the fibroid uterus was diagnosed only after histological examination of an incidental hemorrhagic mass found at laparotomy. The series of 6 cases of ovarian ectopic pregnancy seems to confirm the association, and it must also be noted that mild chronic salpingitis was reported on histopathological examination in only 1 case. No conclusion can be reached on the basis of such a small group of patients.
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PMID:Ovarian pregnancy: association with IUD, pelvic pathology and recurrent abortion. 733 10

Uterine leiomyomata are the most common tumors in women and can cause abnormal uterine bleeding, pelvic pain, and infertility. Approximately 200,000 hysterectomies are performed annually in the U.S. to relieve patients of the medical sequelae of these benign neoplasms. Our efforts have focused on cloning the t(12;14)(q14-q15;q23-q24) breakpoint in uterine leiomyoma to further our understanding of the biology of these tumors. Thirty-nine YACs and six cosmids mapping to 12q14-q15 have been mapped by fluorescence in situ hybridization to tumor metaphase chromosomes containing a t(12;14). One YAC spanned the translocation breakpoint and was mapped to tumor metaphases from a pulmonary chondroid hamartoma containing a t(12;14)(q14-q15;q23-q24) and a lipoma containing a t(12;15)(q15;q24); this YAC also spanned the breakpoint in these two tumors, suggesting that the same gene on chromosome 12 may be involved in the pathobiology of these distinct benign neoplasms.
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PMID:Identification of a YAC spanning the translocation breakpoints in uterine leiomyomata, pulmonary chondroid hamartoma, and lipoma: physical mapping of the 12q14-q15 breakpoint region in uterine leiomyomata. 760 52

25 patients have involved in this research, who have chronic gynecologic pelvic pain and each of them had normal gynecologic examination. Chronic pelvic pain has been found mostly between 30-39 years age group married, multipar females, associated with 44% dysmenorrhea, 36 p. cent dyspareunaie. Cultures and clinical examinations were all negative as a sign of infection. Experienced intra-abdominal operation or infection were causes of pelvic pain (48%), especially appendectomy has a prominent place (75%). Laparoscopic investigation showed: 16 p. cent adhesions, 28 p. cent chronic annexitis, 16 p. cent experienced pelvic inflammatory disease, 8 p. cent uterine leiomyoma, 4 p. cent each endometriosis, experienced parametritis and haemorrhagic lutein cysts. Instead of making group of lesions, we prefer to describe it, in numbers as infection importance coefficient (IIC), which is developed for this research. IIC 0-2 points presents insufficient organic causes, it does not represent the cause of pain. Non organic and non gynecologic reasons must be the cause of pain. Non organic and non gynecologic reasons must be investigated. IIC 3-5 points presents minor experienced intraabdominal infection. Secondary cases like myoma, ovarian cysts, chronic cervicitis should be considered first as reason. IIC 6 points and more presents direct organic deficiency suitable surgery is the treatment of choice of this group.
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PMID:[25 patients undergoing laparoscopy for pelvic pain]. 844 81

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


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