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

In industrialised countries endometritis is a problem which represents an increasing risk to personal health and to society. In almost all cases the inflammatory process which affects the uterine mucosa forms part of a more generalised infection which involves the entire internal genital system (PID). The most important problem associated with pelvic phlogosis is increased sterility, a greater number of ectopic pregnancies and chronic pelvic pain. In order to treat the symptoms of genito-pelvic infection, an early diagnosis and adequate medical therapy are indispensable. In this event it may be possible to prevent invalidating effects on fertility and chronic pelvic pain.
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PMID:[Inflammation of the uterine corpus: endometritis]. 235 11

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.
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PMID:Prolonged retention of fetal bones: intrauterine device and extrauterine disease. 236 50

Serologic markers were evaluated to determine if they could aid in the differential diagnosis of pelvic inflammatory disease in 48 consecutive women seeking evaluation for pelvic pain. On the basis of clinical and microbiologic parameters, 29 patients (60.4%) were diagnosed as having pelvic inflammatory disease. Neisseria gonorrhoeae only was isolated from the cervix of eight (27.6%) patients with pelvic inflammatory disease, five (17.2%) had only Chlamydia, and two (6.9%) had Neisseria and Chlamydia, whereas in 15 (48.3%) patients no pathogen was isolated. Interferon-gamma was present in significantly more sera (p less than 0.025) from patients with pelvic inflammatory disease (65.5%) than from women without pelvic inflammatory disease (15.8%). Sera from 10 healthy women lacked detectable interferon-gamma. In patients with only Neisseria, seven (87.5%) had circulating interferon-gamma; three (60%) of the women with only Chlamydia, one (50%) woman with Neisseria and Chlamydia, and eight (57.1%) with no identified pathogens were also positive for interferon-gamma. Sera from 11 of 28 patients with pelvic inflammatory disease (39%) but only one of 19 sera from women without pelvic inflammatory disease (5%) also inhibited the Candida-induced proliferation of control lymphocytes. This immunosuppressive activity was prevented by immunoprecipitation of interferon-gamma by anti-interferon-gamma antibody but not by treatment with anti-interferon-alpha antibody. The persistence of interferon-gamma in the sera of patients with pelvic inflammatory disease may aid in the differential diagnosis of this disease and increase our understanding of the pathogenesis of microbial-mediated tubal damage.
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PMID:Interferon-gamma in the diagnosis and pathogenesis of pelvic inflammatory disease. 211 Oct 96

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.
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PMID:Pelvic inflammatory disease and the intrauterine contraceptive device. 256 99

A comparison has been made between Lippes loop and T Cu 200 intrauterine contraceptive device with respect to their acceptability and effectiveness in a developing country. A total of 1054 patients were studied: 697 with Lippes loop and 357 with T Cu 200. The ages of the patients ranged between 14 and 44 years, with a peak age of 21-25 years for T Cu 200 and 26-30 for Lippes loop. The event rates were similar but T Cu 200 displayed lower expulsion rate, lower intermenstrual bleeding rate, and a lower incidence of pelvic inflammatory disease. The Lippes loop had lower event rate for other parameters considered, pregnancy and pelvic pain. The continuation rate was similar for both devices. Both devices are useful for women who wish to space out their children but for those who wish to achieve effective contraception for more than 5 years, Lippes loop should be the IUD of choice. (Author's).
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PMID:Comparison of copper T-200 with Lippes loop as a contraceptive device. 256 94

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.
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PMID:Chlamydia trachomatis infections--the Royal Women's Hospital experience. 271 99

Pelvic inflammatory disease is one of the most serious complications of sexually transmitted diseases. It is a medical and public health problem of great magnitude, and adolescents are at greater risk for its development than any other age group. Its sequelae of infertility, ectopic pregnancy, chronic pelvic pain, and dyspareunia may have a devastating impact upon a teenager's life. The epidemiology, pathogenesis, clinical features, differential diagnosis, and management and prevention of this clinical syndrome are presented.
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PMID:Pelvic inflammatory disease in the adolescent. 277 92

This study analyzed 12-months expulsion rates among women who had Delta IUDs (modifications of the Lippes Loop D and the TCu 220C) inserted immediately after delivery. 122 women received the Delta Loop and 124 received the Delta T IUD. 1 failed insertion and 1 case of mild pelvic pain were reported at insertion for Delta Loop group, whereas 5 women in the Delta T group experienced mild pelvic pain. The proportions of women reporting menstruation-related problems at follow-up were similar for both groups. There were no cases of pelvic inflammatory disease, although 2 women in the Delta Loop group had cervicitis. The 12-month expulsion rate was 3.7 for the Delta Loop and 7.6 for the Delta T. Most expulsions occurred in the 1st month after insertion. The 12-month removal rate for bleeding or pain was 1.1 for the Delta Loop and 1.0 for the Delta T. Continuation rates at 12 months were 93.3 for the Delta LOOP and 90.7 for the Delta T. The 12-month accidental pregnancy rate was 2.1 among Delta Loop users; there were no pregnancies in the Delta T group. These findings suggest that expulsions are minimized and the risks of infection and uterine perforation are not increased when IUD insertion is performed within 10 minutes after delivery of the placenta. The addition of biodegradable suture projections in the Delta devices is considered to signficantly reduce the number of explusions relative to standard loops.
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PMID:A study of delta intrauterine devices in Ankara, Turkey. 286 33

One hundred eighty-two women were diagnosed by laparoscopy as having an initial episode of acute pelvic inflammatory disease (PID). The classification of PID was based on a modification of Westrom's criteria. Antibiotic treatment followed recommended protocols established by the Centers for Disease Control (CDC). Each year, the woman is contacted to complete a questionnaire detailing her reproductive history, presence of pelvic pain, and menstrual history, as well as other miscellaneous gynecologic history. The study covers a follow-up interval of six months to 8 years. The results are categorized according to the severity of the acute PID, as well as the time elapsed since the infection. A psychological investigation of post-PID pain was performed, and yielded accurate prediction of whether or not pain had been reported by a patient during the acute phase of the disease. Results indicate an increased incidence of involuntary sterility as the disease progresses in severity. The occurrence of ectopic pregnancy is increased for all stages of PID, but most particularly, following tubo-ovarian abscess. The long-term consequences of a single episode of acute PID are often severe.
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PMID:Acute pelvic inflammatory disease: a clinical follow-up. 288 88

This article reviews current knowledge on the diagnosis, pathogenesis, epidemiology, treatment, and prognosis of pelvic inflammatory disease (PID). Since PID has important implications for future health and fertility, its diagnosis and management are of utmost importance. A recent study of the accuracy of clinical diagnosis of PID indicated that, even when as many as 7 reliable symptoms and signs were present, there was still possibility for diagnostic error. This has led some to advocate diagnostic laparoscopy. In older women, IUD users, and women who have recently delivered or undergone pelvic surgery, endogenous organisms are more likely to be the initial infecting agents. Treatment of PID should be begun before the results of microbiological investigations are available and should cover a wide spectrum of organisms. The author's preference is a combination of penicillin or ampicillin in high dose, gentamicin, and rectal metronidazole. Follow up treatment with tetracycline or erythromycin is needed to eradicate chlamydial infection. The author also prefers to remove an IUD in place once antibiotic cover has been established. The longterm prognosis in such cases is not good, especially after nongonococcal PID. 25% of a group of 415 PID patients followed for 10 years had reinfections and 18% suffered chronic pelvic pain. 21% were involuntarily infertile, and tubal occlusion rates rose from 13% after 1 attack to 75% in those who had been infected 3 or more times. When PID patients did become pregnant, ectopic pregnancy was 6 times more common than in a group of matched controls.
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PMID:Pelvic inflammatory disease. 293 44


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