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

Pelvic Inflammatory Disease (PID) is the most common serious complication of sexually transmitted diseases (STDs). Each year over one million women in the United States experience an episode of PID, with approximately 16-20% of cases occurring in teenagers. Acute PID increases a woman's risk for recurrent PID, chronic pelvic pain, infertility, and ectopic pregnancy. Recent reports indicating that PID rates are rising and are highest among adolescent females aged 15-19 underscore the need to remain current on the clinical as well as the epidemiologic aspects of PID. We present such an update in this article. Trends in incidence and key risk factors are discussed; besides adolescence itself and STD, other important categories of risk factors include sexual activity, contraceptive method, and previous episode(s) of PID. The polymicrobial nature of PID is discussed along with an analysis of the role of specific organisms, such as Chlamydia trachomatis, Neisseria gonorrhoeae, anaerobic and aerobic bacteria, and mycoplasmas in PID. Early diagnosis and the institution of appropriate treatment regimens are essential to the prevention of PID's devastating sequelae. Clinicians must maintain a high index of suspicion for the wide range of clinical presentations associated with PID and be prepared to provide effective management, including proper evaluation and prompt treatment of sexual partners.
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PMID:Pelvic inflammatory disease and its sequelae in adolescents. 389

The rising incidence of pelvic inflammatory disease (PID), coupled with the development of more sophisticated and effective diagnostic techniques, has created a new body of knowledge regarding the microbiology, diagnosis, and natural history of this disease. Acute pelvic inflammatory disease is the major gynecologic health problem in the United States. Distinguishing acute PID from the other causes of acute pelvic pain is often a difficult task. Careful consideration of a patient's risk profile for PID and utilization of the diagnostic techniques available are invaluable in helping the clinician accurately make this differentiation. The microbial spectrum involved in PID is complex and must be taken into consideration when selecting an antibiotic regimen. The recent addition of new, broad-spectrum antibiotics to the physician's therapeutic armamentarium has led to increasingly effective management options. Despite the effectiveness of current medical and surgical therapy, the staggering economic, medical, and social consequences of PID mandates more aggressive efforts at its prevention.
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PMID:Pelvic inflammatory disease. 633 77

Laparoscopy is valuable in the definitive diagnosis of pelvic pain of uncertain aetiology. A clinical diagnosis of pelvic pain was made in 67 patients, but was confirmed by laparoscopy in only 34. In 36 patients in whom a clinical diagnosis of ectopic pregnancy had been made this was confirmed at laparoscopy in 21, while six of 26 positive laparoscopic diagnoses of ectopic pregnancy were unsuspected clinically. Acute pelvic inflammatory disease was diagnosed correctly on clinical grounds in only eight of 22 patients; in the other 16 patients the diagnosis was first made at laparoscopy. In these 16 patients there was poor correlation with the bacteriological results of cervical smears and cultures. Of 30 patients in whom a preoperative clinical diagnosis had not been made, laparoscopy showed normal pelvic viscera in 12. Similarly, in another eight of the 68 patients thought to have organic pelvic pathology on clinical grounds, the laparoscopic findings were normal. Apart from establishing a definitive diagnosis, laparoscopy has been found to be a safe procedure, and one of considerable cost effectiveness in terms of hospital stay.
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PMID:Diagnostic laparoscopy: role in management of acute pelvic pain. 645 17