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

Laparoscopy was performed in 130 patients with chronic pelvic pain. Laparoscopy confirmed the preoperative diagnosis of pelvic inflammatory disease (PID) in 41 of 63 women with preoperative diagnosis of chronic PID (65%), whereas in 8 (13%), no pathologic findings were revealed. Laparoscopy directed the management in all 67 women who underwent the procedure to establish a diagnosis; in 16 (24%) of these, no pathologic findings were revealed. Of the total group, laparoscopy prevented laparotomy in 20 cases. These results are in accord with those of previous studies and emphasize the importance of laparoscopy in the management of women with chronic pelvic pain.
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PMID:The diagnostic value of laparoscopy in women with chronic pelvic pain. 296 Dec 94

A group of 600 IUD users aged 26 to 35 were studied. 440 women were married; 434 were pluriparae and 166 nulliparae. 24 (5.5%) had undergone cesarean section, and 266 (44.3%) had had induced abortion. 23% of single women had opted for voluntary termination of pregnancy, while 72% had previous experience with IUDs or oral contraceptives. 273 (45.5%) relied on behavioral methods of contraception, 33 (5.5%) used the diaphragm, 279 (46.5%) used pills, 124 (20.6%) used condoms (50.6%) used ML-250 IUD, 144 (24%) used Progestasert, 87 (14.5%) used Gravigard, 42 (7%) used Minigravigard, 18 (3%) used Nova-T, 4 (0.6%) used Anticon, and 1 (0.1%) relied on No-Gravid. The IUD was removed prematurely in 119 cases, 339 were removed at the end of usefulness, dropout occurred in 51 cases, and expulsions in 14 cases. IUD failure was registered in 103 cases corresponding to 21.8% of the total. Bleeding caused 31 instances, 22 were due to dislocation, there were 15 intra -uterine pregnancies, 14 expulsions, 11 cases of pelvic pain, 4 cases of pelvic inflammatory disease, 3 cases of extrauterine pregnancy, and 3 other failures of IUDs. 31% of failures occurred in the 31-35 age group, and 40% of nulliparous women had IUD experience, but only 22.8% had a positive experience. 83.9% of those who used progesterone-containing pills had success with them, only 16.1% failed. Pluriparae over 30 used Progestasert most successfully. Nulliparous women did not represent the ideal candidates for IUD use, previous positive experience was an important element of success, while less important factors were age and abortion history.
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PMID:[Experience with intrauterine contraception. Survey of 600 IUD users at the S. Anna University Hospital in Rome]. 305 39

An analysis of published studies of the effect of antibiotic prophylaxis associated with vacuum aspiration abortion includes an examination of risk factors for pelvic inflammatory disease (PID), cervical and vaginal flora present in early pregnancy and in PID, the effect of surgical scrub and of prophylaxis on flora, principles of antibiotic prophylaxis, and economic costs of PID. From several prospective studies, it is clear that nulliparas, women with a history of PID, those bearing Chlamydia trachomatis are at risk of post-abortion infection. No risk was associated with pelvic pain, dysmenorrhea, social class, insertion of an IUD, or timing of resumption of coitus. After an extensive enumeration of microbes found in nonpregnant, pregnant, and PID female genital tracts, it was concluded that only C. trachomatis and N. gonorrheae are clearly associated with PID, while the importance of several other microbes is unclear. Quantitative counts of organisms in any condition are lacking. PID is polymicrobial; different organisms probably account for noniatrogenic PID and post-surgical PID. There is evidence that surgical cleansing of the vagina has no bearing on incidence of post-abortal PID, since the responsible organisms come from the endocervix. 5 controlled clinical trials demonstrated that antibiotic prophylaxis is warranted; that penicillin/ampicillin selectively reduced PID in women with PID history; that imidazoles preferentially reduce PID in the general population without PID history. No lasting side effects or emergence of resistant organisms was reported. The treatment was cost effective, cutting health costs and labor losses 5-8%, and reducing the incidence of spontaneous abortion, secondary infertility, and chronic pain.
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PMID:Pelvic inflammatory disease following induced first-trimester abortion. Risk groups, prophylaxis and sequelae. 327 98

The ovarian remnant syndrome, an unusual complication of bilateral oophorectomy, usually presents with pelvic pain with or without a mass. From 1980-1985, 31 patients were seen with this diagnosis, which was confirmed by excision of ovarian tissue. Various adhesion-producing conditions leading to retention of ovarian tissue, such as endometriosis, pelvic inflammatory disease, or inflammatory bowel disease, were present at the original procedure. The increase in diagnosis of this condition during the past five years may represent a greater awareness of the potential condition, combined with wider use of ultrasonography and computed tomography scanning. Twenty of the 31 patients were found to have a tender palpable mass of thickening. In 11 patients, a mass was found only on ultrasonography. Surgical correction required dissection and mobilization of the ureter throughout its entire pelvic course to facilitate resection of the specimen. The complications were minor, and symptoms were relieved.
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PMID:Ovarian remnant syndrome: diagnostic dilemma and surgical challenge. 328 Oct 76

Chronic pelvic pain is one of the most challenging gynecologic problems seen in primary care practice. Important causes of this problem include endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and the syndrome of chronic pelvic pain without obvious pathology. The diagnostic approach to chronic pelvic pain begins with a careful medical history and physical examination in conjunction with a comprehensive psychosocial assessment. Laboratory evaluation may include pelvic ultrasonography, psychometric testing, and diagnostic laparoscopy. Optimal management of these patients may require a multidisciplinary approach, integrating chronic pain management techniques with specific therapy.
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PMID:Chronic pelvic pain. 330 67

Disorders of urachal remnants are uncommon. While a urachal cyst usually is asymptomatic, infection may mimic a variety of acute intra-abdominal or pelvic processes. We describe 10 patients in 2 distinct age groups (the young child and the young adult) with an infected urachal cyst. The presenting symptoms and signs in most patients included dysuria, severe lower abdominal pain and fever. In 7 patients the correct preoperative diagnosis was made. Diagnoses at referral included Crohn's disease, bladder carcinoma and pelvic inflammatory disease. A single procedure was performed in 7 cases and a staged technique was used in 3. The differential diagnosis of acute abdominal and pelvic pain or a midline lower abdominal mass in the pediatric or young adult age group should include infection of a urachal remnant.
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PMID:Infected urachal cysts: a review of 10 cases. 339 41

Consultant genitourinary physicians were asked about facilities for chlamydial diagnosis and their perception of the need for this service. A wide range of facilities was available, but eight respondents had no access to a chlamydial diagnostic service (CDS). Epidemiological treatment was widely practised as a substitute for chlamydial diagnosis; some clinicians used a CDS as an adjunct to epidemiological treatment, but few clinicians based their treatment of female contacts of men with non-gonococcal urethritis on the results of a test for chlamydial infection. All respondents felt that a CDS was essential in some situations, although there was a difference of opinion about the extent of the CDS. Most clinicians believed that all or most women should be tested, but the need for testing men routinely was more controversial. Although a CDS is costly, many clinicians believed that early diagnosis was a cost effective procedure if it prevented the long term sequelae of pelvic inflammatory disease--ectopic pregnancy, chronic pelvic pain, and probably infertility.
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PMID:Chlamydial diagnostic services in the United Kingdom and Eire: current facilities and perceived needs. Royal College of Physicians Committee on Genitourinary Medicine. 342 93

A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances).
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PMID:Sequelae of induced first-trimester abortion. A prospective study assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics. 352 43

Complications associated with postabortion insertion of the Delta T and Copper T 200 IUDs were compared in 195 women. All insertions were performed with an inserter. There were no reported incidents of inserter-related problems, pelvic pain, or other complications at insertion. At follow-up, intermenstrual spotting was the most frequently reported complaint, involving 14 women (18.2%) in the Delta T group and 7 women (9.5%) in the TCu group. 8 Delta T acceptors (10.4%) and 12 TCu acceptors (16.2%) experienced intermenstrual bleeding. Intermenstrual pain was reported by 7 (9.1%) Delta T users and 4 (5.4%) TCu users. Other primary bleeding and pain complaints included menorrhagia, reported by 9 (11.7%) Delta T users and 9 (12.2%) TCu users, and dysmenorrhea, reported by 5 (6.5%) Delta T users and 4 (5.4%) TCu users. Pelvic inflammatory disease (PID) confined to the uterus was diagnosed in 9 (11.7%) Delta T acceptors and 5 (6.8%) TCu acceptors. 7 women (9.1%) in the Delta T group and 8 women (10.8%) in the TCu group reported PID confined to the adnexa. 1 woman from each group had PID confined to the uterus and adnexa and 5 TCu users reported PID beyond the uterus and adnexa. Of the 36 women diagnosed with PID, 9 had their devices removed. There was 1 pregnancy in the Delta T group and 1 device from each group was expelled. There were 3 removals for pain and bleeding in the Delta T group and 4 removals for this reason in the TCu group. The 6-month continuation rate was 85.5 for the Delta T device and 82.2 for the TCu IUD. Given the high incidence of spotting, intermenstrual bleeding, and PID recorded in this sample, insertion of an IUD in the immediate postabortion period is not recommended.
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PMID:A comparison of the delta copper T and the copper T 200 in Bologna, Italy. 372 92

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


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