Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prolonged intrauterine retention of fetal bone parts is a rare complication of induced abortion, spontaneous intrauterine fetal death, and missed abortion. Here, a case of long-term retention of fetal bone fragments in a 47-year-old Italian women who underwent elective abortion 8 years earlier is reported. The patient was admitted for acute pelvic pain with purulent vaginal discharge. She reported recurrent episodes of abdominal and pelvic pain, meteorism, dysuria, nausea and vomiting, headaches, and irregular cycles with dysmenorrhea and inter menstrual bleeding since the 1979 abortion. Initially, pelvic inflammatory disease was diagnosed and antiphlogistic drugs were prescribed. When symptoms persisted after 10 days of drug treatment, the patient underwent a laparotomy that revealed pyosalpinx with extensive pelvic adhesions. Total hysterectomy with bilateral adnexectomy was performed. The uterine cavity was found to be closely packed with fragments that were determined at stereomicroscopic examination to be pieces of fetal bone. Of particular concern is the potential of this complication to lead to secondary infertility. The retained bone fragments can function similarly to an IUD by producing an increase in the local insertion of prostaglandins and preventing blastocyst implantation. Moreover, the retained fragments are an ideal substrate for bacterial colonization, which can spread to the tubes and destroy the functional integrity of the reproductive apparatus. Retention of fetal bones should thus be considered as a possible etiologic factor in cases of infertility of women with a history of abortion.
 ...
PMID:Prolonged retention of fetal bones: intrauterine device and extrauterine disease. 236 50

1054 women who were attending the Family Planning Clinic of Jos University Teaching Hospital (Nigeria) were studied for possible causes of pelvic inflammatory disease (PID) over the May 1983-December 1985 period. 697 women were wearing a Lippes Loop and 357 were wearing a T Cu 200. The IUDs had been inserted by trained nurses using an aseptic technique after careful screening to exclude existing PID. PID was diagnosed primarily by clinical means; fever, acute pelvic pain, vaginal discharge, pelvic tenderness or mass, and a raised white cell count were the symptoms. 62 patients developed PID, 35 with moderate or severe PID needing admission and the remaining 27 with mild PID. The overall incidence of PID in IUD users was 5.9%. During the same period 8 patients developed PID among 533 clients using oral contraceptions. An incidence of 1/30 was recorded for hospitalization of IUD wearers and 1/76 for non-IUD users, giving an incidence 2.5 times greater in IUD wearers. Only 44 patients (4.2%) had used the IUD for over 2 years; only 1 of these patients developed PID, a severe case. There was a decline in the number of patients who developed PID with increased duration of use and the relationship between PID and increased duration of use was significant. The response to chemotherapy was dramatic; only 1 course of therapy was necessary for all patients but 2 who required a subsequent course of tetracycline for complete resolution. There was no relationship between the parity of patients and their developing PID.
 ...
PMID:Pelvic inflammatory disease and the intrauterine contraceptive device. 256 99

During the 18-month period from December 1, 1985 to May 31, 1987 Chlamydia trachomatis was the most-common sexually-transmitted agent to be identified at the Royal Women's Hospital, Melbourne. It was isolated from 4% of all specimens for which such culture was requested and was found five-times more frequently than was Neisseria gonorrhoeae. A review of the clinical presentation and the management of the 100 public patient for this period whose cervical specimens were found to give positive results for the presence of chlamydiae revealed that 77% of the women were less than 25 years of age, 78% of the women were single and 65% of the women were nulliparous. Thirty-five women were asymptomatic carriers of chlamydiae. Of the remaining 65 patients with symptoms, 46% experienced pelvic pain, 39% experienced a vaginal discharge and 26% experienced irregular bleeding. The importance of abnormal bleeding is emphasized. In patients who presented for therapeutic abortions, morbidity occurred in 19% of those who were carriers of Chl. trachomatis; accordingly, screening for chlamydiae as routine is recommended in such patients. Furthermore, because of the risk of pelvic inflammatory disease and its consequences, it is important not only to treat female patients in whom chlamydiae have been isolated, but also to treat and to follow-up their sexual partners simultaneously.
 ...
PMID:Chlamydia trachomatis infections--the Royal Women's Hospital experience. 271 99

Health workers took urethral samplers from 218 men with urethritis and 1850 women to screen for Chlamydia trachomatis using culture and immunofluorescence. All the men and women presented themselves at the Hospital Provincial de Franceville in semirural Gabon. 18% of men, 18% of women with vaginal discharge, 14% of women with pelvic pain, 10% of infertile women, and 10% of postpartum women tested positive for C. trachomatis infection. Postpartum women less than 21 years old had a significantly higher chlamydial prevalence than did older postpartum women (18 vs. 5%; p .05). Chlamydial prevalence among 21-25 year old postpartum women was significantly lower than among same age women presenting with other conditions (5% vs. 15% for infertile women, 21% for women with pelvic pain, and 2% for women with vaginal discharge; p .01). Except for postpartum women, older than 25 chlamydia prevalence decreased after age 25. The sensitivity of immunofluorescence ranged from 77% for infertile women to 93% for postpartum women. Its specificity ranged from 97% for women with discharge or pelvic pain to 100% for men. Thus, the direct immunofluorescence test corresponded well with culture. The isolation rates for asymptomatic women neared those of symptomatic women, indicating that most women with C. trachomatis infections have no or very mild symptoms and do no seek medical attention. This most likely jeopardizes their fertility.
 ...
PMID:Urogenital Chlamydia trachomatis in Gabon: an unrecognised epidemic. 306 Apr 22

A review was made of clinical and laboratory findings in 104 women who, during 1978 to 1981, were subjected to laparoscopy because of symptoms suggestive of acute salpingitis, and who harbored Chlamydia trachomatis but not Neisseria gonorrhoeae in the genital tract. The patients with acute salpingitis (N = 76) did not differ significantly from those with visually normal fallopian tubes (N = 28) in regard to age distribution, parity, contraceptive method used, proportion of women with urethritis symptoms, increased vaginal discharge, vomiting, diarrhea, elevated rectal temperature, elevated white blood cell count, and palpable pelvic masses. The acute salpingitis patients more often had irregular bleeding and an elevated erythrocyte sedimentation rate, whereas the patients without acute salpingitis more often had a short history of pelvic pain. The two groups overlapped considerably with respect to the number of symptoms and clinical signs of pelvic infection. The results emphasize the value of laparoscopy in the diagnosis or exclusion of a tubal infection in association with a chlamydial genital infection and pelvic pain, even if there are comparatively few additional symptoms of ascending infection.
 ...
PMID:Laparoscopy in women with chlamydial infection and pelvic pain: a comparison of patients with and without salpingitis. 621 34

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.
 ...
PMID:Vaginal colonization of Escherichia coli and its relation to contraceptive methods. 634 27

Endometriosis was encountered in 66 of 140 patients (47%) who underwent laparoscopy for chronic pelvic pain at Boston Children's Hospital Medical Center. Pelvic pain associated with this diagnosis was both cyclic and acyclic and typically began 2.9 years after menarche. Other symptoms included irregular menses, gastrointestinal and bladder symptoms, and increased vaginal discharge. The diagnosis of endometriosis had not been made preoperatively in the majority of patients despite repeated pelvic examinations and thorough evaluation of the gastrointestinal and urinary tracts. Psychiatric referral had been recommended for 10 patients. The most constant physical finding preoperatively was tenderness with or without cul-de-sac nodularity. Eleven patients (17%) with biopsy-proved endometriosis has normal pelvic examinations. Fifty-eight percent of patients had early and minimal disease (stage I). In the remaining patients, the disease was more extensive, involving the ovaries, tubes, and/or adjacent pelvic structures (stages II-IV). Although in most instances the implants were typical in appearance, in 13 patients (20%) the disease was not recognizable grossly, but was confirmed morphologically. The regimens utilized as primary treatment were based on the stage of the disease and consisted of either ovulation suppression alone or surgery with or without subsequent ovulation suppression. A satisfactory outcome was achieved in 47 patients (71%). The remaining 19 patients (28%) who did not respond to primary treatment were either operated on or treated symptomatically and are being carefully followed.
 ...
PMID:Adolescent endometriosis. 645 89

Sexual health is a part of total health. Sexual problems can cause marital dissolution and emotional impoverishment. The physician is seen as a wise authority figure often and one who can provide sexual guidance and counsel. To be an effective counselor, an obstetrician/gynecologist must acquire sexual knowledge, comfort, and counseling skills. A sexual history is a recommended routine--as part of the new workup, when management of organic problems and treatment (mastectomy, hysterectomy, radical vulvectomy) necessitate inquiry into the patient's sexual practices and sexual value system, and when the patient presents with suspected "functional" or obscure complaints (hyperventilation, palpitations, chronic pelvic pain, recurrent vaginal discharge without obvious pathogens, chronic concerns that everything is all right "down there", cancerphobia). The sexual problem history is readily applicable, especially when a patient presents with an explicit sexual concern. The PLISSIT method is a paradigm that can be utilized effectively with usual referral for intensive therapy (sex therapy) if sexual counseling is ineffectual. The obstetrician/gynecologist can play an important role in facilitating healthful sexual changes in women and couples, enhancing intimacy, and enriching the marital bond.
 ...
PMID:Sexual counseling for the nontherapist. 648 19

To determine the factors associated with the presence of actinomyces-like organisms on cervicovaginal Papanicolaou smears in users of the intrauterine contraceptive device (IUD), we carried out a case-control study. Among about 80,000 Papanicolaou smears examined in one year in a large cytology laboratory, actinomyces-like organisms were identified on 107 smears; all but three smears were from IUD users. Compared with IUD users who did not have actinomyces-like organisms on Papanicolaou smears, those with actinomyces-like organisms had used the IUD for more years. An increased risk of actinomyces-like organisms on Papanicolaou smear was not apparent until 7 years of IUD use, however. No significant association of actinomyces-like organisms with the type of IUD was found after controlling for differences in duration of use between users of various IUDs. The percentage of women reporting gynecologic symptoms (vaginal discharge, pelvic pain, abnormal bleeding) also did not differ significantly between IUD users with and without actinomyces-like organisms on Papanicolaou smear (p = 0.5).
 ...
PMID:Factors associated with actinomyces-like organisms on Papanicolaou smear in users of intrauterine contraceptive devices. 682 23

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.
 ...
PMID:Chlamydia trachomatis infections in women with urogenital symptoms. 713 48


1 2 3 4 5 6 Next >>