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

A case report of an isolated hydrosalpinx resulting from the placement of two Hulka Clips on the same fallopian tube is presented. This is a previously unreported complication of mechanical sterilization and is suggested as a possible cause of chronic pelvic pain.
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PMID:Hulka Clip application as a potential cause of chronic pelvic pain. 151 64

Laparoscopic oophorectomy or salpingo-oophorectomy was performed in 24 women using bipolar coagulation followed by scissors division of the infundibulopelvic ligament, the utero-ovarian ligament, and the broad ligament. Indications were pelvic pain secondary to ovarian adhesions from previous hysterectomy (nine cases, four with palpable masses), pelvic pain secondary to ovarian endometrioma (six cases, three with endometrioma greater than 10 cm); postmenopausal palpable ovary (five cases); pelvic mass secondary to dermoid cyst (one case); pelvic pain and mass secondary to large hydrosalpinx and ovarian endometrioma (two cases), and bilateral ovarian ablation for autoimmune disease (one case). There were no intraoperative or late complications. Relative safety of the procedure is acknowledged, with emphasis placed on meticulous surgical technique and knowledge of retroperitoneal anatomy.
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PMID:Laparoscopic oophorectomy and salpingo-oophorectomy in the treatment of benign tubo-ovarian disease. 288 89

Two women who had been sterilized by tubal ligation or cautery experienced recurrent pelvic pain several years later, and cystic adnexal masses were recognized in both patients. Both patients had bilateral hydrosalpinges with unilateral torsion and gangrene. These cases suggest there may be a predisposition to hydrosalpinx and tubal torsion following tubal ligation if the fimbriated end of the fallopian tube becomes occluded. Awareness of this potential complication may lead to increased recognition and earlier intervention in patients who have undergone tubal ligation.
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PMID:Hydrosalpinx and tubal torsion: a late complication of tubal ligation. 395 95

Pelvic inflammatory disease (PID) is a common infection in women of reproductive age. PID is actually a spectrum of disease, beginning with cervicitis and progressing to endometritis and eventually salpingitis. Sequelae include ectopic pregnancy, infertility, chronic pelvic pain, hydrosalpinx, and tubo-ovarian abscess. Neisseria gonorrhoeae and Chlamydia trachomatis are the primary causes of PID. Chlamydial infection may be asymptomatic, and the resulting salpingitis is often referred to as "silent PID." Polymicrobial infection with other organisms (eg, anaerobes, facultative aerobes) may be initiated by gonorrhea, chlamydial infection, or both. Early recognition of infection, prompt institution of appropriate antibiotic therapy, and proper follow-up are important to prevent the sequelae of PID. Patient education is essential to reduce the incidence of PID.
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PMID:Pelvic inflammatory disease. Current diagnostic criteria and treatment guidelines. 843 60

The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal-neurological, gastrointestinal, or myofascial. A psychological component almost always is a factor, whether as an antecedent event or presenting as depression as result of the pain. Surgical interventions for chronic pelvic pain include: 1) resection or vaporization of vulvar/vestibular tissue for human papillion virus (HPV) induced or chronic vulvodynia/vestibulitis; 2) cervical dilation for cervix stenosis; 3) hysteroscopic resection for intracavitary or submucous myomas or intracavitary polyps; 4) myomectomy or myolysis for symptomatic intramural, subserosal or pedunculated myomas; 5) adhesiolysis for peritubular and periovarian adhesions, and enterolysis for bowel adhesions, adhesiolysis for all thick adhesions in areas of pain as well as thin ahesions affecting critical structures such as ovaries and tubes; 6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx; 7) ovarian treatment for symptomatic ovarian pain; 8) uterosacral nerve vaporization for dysmenorrhea; 9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder origin; 10) resection of endometriosis from all surfaces including removal from bladder and bowel as well as from the rectovaginal septal space. Complete resection of all disease in a debulking operation is essential; 11) appendectomy for symptoms of chronic appendicitis, and chronic right lower quadrant pain; 12) uterine suspension for symptoms of collision dyspareunia, pelvic congestion, severe dysmenorrhea, cul-desac endometriosis; 13) repair of all hernia defects whether sciatic, inguinal, femoral, Spigelian, ventral or incisional; 14) hysterectomy if relief has not been achieved by organ-preserving surgery such as resection of all endometriosis and presacral neurectomy, or the central pain continues to be disabling. Before such a radical step is taken, MRI of the uterus to confirm presence of adenomyosis may be helpful; 15) trigger point injection therapy for myofascial pain and dysfunction in pelvic and abdominal muscles. With application of all currently available laparoscopic modalities, 80% of women with chronic pelvic pain will report a decrease of pain to tolerable levels, a significant average reduction which is maintained in 3-year follow-up. Individual factors contributing to pain cannot be determined, although the frequency of endometriosis dictates that its complete treatment be attempted. The beneficial effect of uterosacral nerve ablation may be as much due to treatment of occult endometriosis in the uterosacral ligaments as to transection of the nerve fibers themselves. The benefit of the presacral neurectomy appears to be definite but strictly limited to midline pain. Appendectomy, herniorraphy, and even hysterectomy are all appropriate therapies for patients with chronic pelvic pain. Even with all laparoscopic procedures employed, fully 20% of patients experience unsatisfactory results. In addition, these patients are often depressed. Whether the pain contributes to the depression or the depression to the pain is irrelevant to them. Selected referrals to an integrated pain center with psychologic assistance together with judicious prescription of antidepressant drugs will likely benefit both women who respond to surgical intervention and those who do not. A maximum surgical effort must be expended to resect all endometriosis, restore normal pelvic anatomy, resect nerve fibers, and treat surgically accessible disease. In addition, it is important to provide patients with chronic pelvic pain sufficient psychologic support to overcome the effects of the condition, and to assist them with underlying psychologic disorders.
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PMID:Surgical treatment for chronic pelvic pain. 987 26

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

A 37-year-old woman was seen for pelvic pain. Ultrasonography and laparoscopy led to the diagnosis of bilateral hydrosalpinx. Analgesics and antibiotics were given several times but the clinical picture worsened. Laparotomy was performed and disclosed bilateral hydatidosis of the fallopian tubes requiring bilateral salpingectomy. Postoperatively, hydatic serology was strongly positive and a calcified hydatic splenic cyst was identified. Medical treatment with albendazole was prescribed for these multiple localizations of hydatid cysts.
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PMID:[Hydatic cyst of the fallopian tube: a case report]. 1205 46

210 puerperally sterilized women (1-20 years age) and 500 women of similar age and parity served as the experimental and control groups in a Calcutta hospital study. 96% of the sterilized women had the operation for socioeconomic reasons and multiparity. At sterilization mean age was 27 years 10 months and mean parity was 4.8. The group after sterilization had significantly higher rates of menorrhagia (27.6%), dysmenorrhea (18.09%), and pelvic pain (10%) than had the controls. Rates of dyspareunia and excess libido were 2.3% and 5.2% in the sterilized women, as compared with nil rates in the controls. After operation rates of hydrosalpinx, pelvic adhesions, abdominal incision hernias, and scar endometriosis were 4.76%, 3.8% 4.7%, and .4%, respectively. No significant psychological sequelae occurred. The pregnancy rate after sterilization was .4%. It is concluded that sterilization will be more acceptable to poor women if the method can be improved so less side effects occur.
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PMID:Female sterilisation as a method of population control. Presented at the 14th All India Obstetric and Gynecology Congress, Nagpur, November 26-28, 1967. 1233 19

Isolated torsion of hydrosalpinx is a rare cause of acute pelvic pain. Pre-operative diagnosis is very difficult because of non specific clinical presentation. Definitive diagnosis is always made at surgical exploration performed for suspected adnexal torsion and salpingectomy is performed in the majority of cases. A 34-year-old woman was admitted for acute pelvic pain with nausea and vomiting. Vaginal examination revealed a right adnexal tender mass and ultrasound revealed a well circumscribed right adnexal cystic mass. Surgical exploration has revealed torsion of a right hydrosalpinx and right salpingectomy was performed. Differential diagnosis between adnexal and tubal torsion is very difficult, however both should be managed by rapid surgical exploration which an allow precocious diagnosis and conservative treatment.
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PMID:Uncommon cause of acute pelvic pain: isolated torsion of hydrosalpinx. 2069 Feb 82

Pelvic pain presents a common diagnostic conundrum with a myriad of causes ranging from benign and trivial to malignant and emergent. We present a case where a mucinous neoplasm of the appendix acted as a mimic for tubular adnexal pathology on imaging. With the associated imaging findings on ultrasound, computed tomography, and magnetic resonance imaging, we wish to raise awareness of mucinous tumors of the appendix when tubular right adnexal pathology is present both in the presence of pelvic or abdominal pain or when noted incidentally. Tubular pathology such as uncomplicated paraovarian cysts or hydrosalpinx is frequently treated conservatively with long-interval follow-up imaging or left to clinical follow-up. Thus, if incorrectly diagnosed as tubular pathology, an appendix mucocele or mucinous neoplasm of the appendix is likely to be undertreated. We wish to clarify some of the confusion around nomenclature and classification of the multiple entities that are comprised by the terms mucocele and mucinous tumor of the appendix.
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PMID:Mucinous Neoplasm of the Appendix as a Mimic of Cystic Adnexal Pathology. 3019 23


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