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

Diagnostic laparoscopy performed during an infertility evaluation identified 80 patients with hydrosalpinges (12% of all laparoscopic examinations performed for infertility). Despite these findings, only 20 (25%) of these patients reported a prior episode of acute pelvic inflammatory disease (PID), and only 18 (22.5%) had complaints of pelvic pain. Compared with a matched group of infertility patients with no endoscopic evidence of prior pelvic infection, those patients with hydrosalpinges were more likely to have used an intrauterine device and were less likely to have used an oral contraceptive. Since "silent" PID is a potential cause of infertility, endoscopic visualization of the female reproductive organs should be considered during the infertility evaluation. Moreover, in view of its insidious nature, the diagnosis of PID should be considered in a young sexually active patient with gynecologic complaints.
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PMID:Unsuspected chronic pelvic inflammatory disease in the infertile female. 621 87

Ectopic pregnancy is the leading cause of maternal death in the first trimester. Its incidence is increasing, probably owing to the increasing incidence of pelvic inflammatory disease. Although up to 15% of patients have been reported to present in shock, a large number seek care earlier because of pelvic pain and irregular menses. With strong clinical suspicion and the use of culdocentesis, assays of the beta subunit of human chorionic gonadotropin in the blood and ultrasonography, the diagnosis can be made before rupture occurs. Although the woman's subsequent fertility has traditionally been poor, some improvement has been achieved with the use of conservative surgical techniques. Early diagnosis facilitates this approach.
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PMID:Update on ectopic pregnancy. 622 91

Laparoscopy was used to verify the diagnosis of acute pelvic inflammatory disease (PID) in 112 patients. The patients were all hospitalized and treated with intensive intravenous antibiotics and followed closely postoperatively for as long as 4 years. A follow-up questionnaire concerning pelvic-abdominal pain, menstrual distrubances, pelvic-venereal infection, contraception, and pregnancy was completed and returned by 81 of the 112 patients. The corrected pregnancy rate was 44% during the follow-up period with only 1 ectopic pregnancy occurring. Reinfection was noted in 11%, residual abdominal or pelvic pain in 21% menstrual abnormalities in 15%, and contraceptive use in 20%. The diagnosis, treatment, and prognosis of acute PID is reviewed briefly.
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PMID:Acute pelvic inflammatory disease: follow-up in laparoscopically confirmed cases. 623 Mar 40

One hundred twelve females below the age of twenty years underwent laparoscopy at the Medical University of South Carolina over a ten-year period. Pelvic pain followed by primary amenorrhea was the major indication for the procedure. Eighty-nine percent of those with acute pain had identifiable pelvic pathology, whereas 27% of girls presenting with chronic pain had a normal laparoscopic examination. Pelvic inflammatory disease was the most common diagnosis. Ovarian cysts, pregnancy complications, and endometriosis were also found. Endometriosis was not found among black teenage clinic patients. The procedure appears to be a safe and useful diagnostic tool in this age group.
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PMID:Laparoscopy in children and adolescents. 623 18

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

Peritoneal fluid obtained at laparoscopy from 49 women was measured for its content of prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha), 6-keto-prostaglandin F1 alpha (6-KF), and thromboxane B2 (TxB2) by specific radioimmunoassays. In normal women (n = 10), the concentrations of prostaglandins in peritoneal fluid were (mean +/- SE): PGE2 = 0.79 +/- 0.26, PGF2 alpha = 0.60 +/- 0.18, 6-KF = 0.48 +/- 0.19, and TxB2 = 0.23 +/- 0.09 ng/ml; in women with endometriosis (n = 16): PGE2 = 1.43 +/- 0.72, PGF2 alpha = 1.52 +/- 0.59, 6-KF = 3.32 +/- 0.71, and TxB2 = 1.14 +/- 0.69 ng/ml; in women with chronic pelvic inflammatory disease and/or obstructed tubes (n = 19): PGE2 = 1.94 +/- 1.04, PGF2 alpha = 1.20 +/- 0.61, 6-KF = 1.55 +/- 0.40, and TxB2 = 0.64 +/- 0.24 ng/ml; in women with pelvic pain without any visible pathologic condition (n = 4): PGE2 = 1.11 +/- 0.66, PGF2 alpha = 0.73 +/- 0.55, 6-KF = 1.35 +/- 0.35, and TxB2 = 0.39 +/- 0.17. The mean volumes of peritoneal fluid recovered were 10 to 16 ml and were not significantly different between the groups. Except for a significantly elevated concentration of 6-KF in the peritoneal fluid of women with endometriosis compared to normal women (p = less than 0.02), the prostaglandins measured did not differ significantly between the groups of women studied. The possible significance of elevated 6-KF in the peritoneal fluid of women with endometriosis is discussed.
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PMID:Peritoneal fluid prostaglandins and prostanoids in women with endometriosis, chronic pelvic inflammatory disease, and pelvic pain. 636 10

A series of 90 endometrial biopsies and curettings originally diagnosed as chronic endometritis were reviewed and histological findings of plasma cells, lymphoid infiltrate, stromal necrosis, acute inflammation, lymphoid follicles, and epithelial atypia were correlated with the demonstration of chlamydial antigens by the immunoperoxidase technique. Chlamydial antigens were localized within endometrial epithelial cells in four cases. Although these four cases represented only 4% of the total number, chlamydial immunoperoxidase positivity was best discriminated by the severity of the inflammation and the presence of an acute inflammatory infiltrate. Among cases of severe endometritis 22% were chlamydia-positive, and in those cases with an associated acute inflammatory infiltrate, 57% were positive. A high index of suspicion of chlamydial infection should exist when severe endometritis is diagnosed in patients with clinical histories of post-abortal state, pelvic inflammatory disease, secondary infertility or menometrorrhagia, and chronic pelvic pain.
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PMID:Chlamydial endometritis. A histological and immunohistochemical analysis. 638 66

Few previous studies have examined the relationship between the preoperative and pathologic diagnoses for hysterectomy. To determine the percentage of preoperative diagnoses that were confirmed by pathologic examination, we analyzed data from the Collaborative Review of Sterilization, a multicenter study of hysterectomies and tubal sterilizations in women aged 15 to 44 years. Data were collected from patient interviews and chart reviews. Of the 1851 women included in this study, 1283 (69%) had abdominal hysterectomies and 568 (31%) had vaginal hysterectomies. Overall, 52% of the hysterectomies were performed for a preoperative diagnosis that could potentially be confirmed by pathologic examination. Pathologic examination actually confirmed the preoperative diagnosis of endometrial hyperplasia in 95% of the cases, cervical intraepithelial neoplasia in 89%, leiomyomas in 84%, pelvic inflammatory disease in 75%, adenomyosis in 48%, and endometriosis in 47%. Among all of the potentially confirmable diagnoses, 80% were confirmed. The remaining 48% of the women who had hysterectomies had preoperative diagnoses that were not amenable to confirmation by pathology. Most of these were for one of three diagnoses: menstrual bleeding disorders, pelvic pain, or pelvic relaxation. In 47% of these cases, pathologic examination showed leiomyoma or adenomyosis; no abnormalities were found in 38% of these cases.
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PMID:Confirmation of the preoperative diagnoses for hysterectomy. 648 93

The study objective was to record the incidence of Chlamydia trachomatis infections among patients admitted for legal abortion in Ullevaal Hospital (Oslo, Norway) and to follow those women harboring chlamydia, particularly those in whom it caused postoperative infections. 218 women admitted consecutively for abortion in the 1st trimester in 1980 were included in the study. The abortion procedure used was dilatation and vacuum aspiration. The diagnosis of pelvic inflammatory disease (PID) was made on the clinical basis of pelvic pain, adnexal masses, increased erythrocyte sedimentation rate, and fever. Patients who developed acute salpingitis were treated with doxycycline. Patients who harbored C trachomatis were recalled for follow up about 3 months after the abortion. Of the 218 patients, C trachomatis was isolated from the cervix in 30 (13.8%), N gonorrheae in 2 (2.8%), and both C trachomatis and N gonorrheae in 2. 7 of the 30 (23.3%) patients harboring C trachomatis developed PID. All the infections occurred in the 1st 2 weeks after the abortion. None of the patients with cervical gonorrhea developed salpingitis. 21 of the chlamydia positive patients attended for follow up 3 months after the abortion. Of the 7 patients with pelvic infection, 6 attended. 4 of these women had an appreciable rise in chlamydial IgG antibody titre while 2 had raised but unchanged titres. Another 4 patients had a 4-fold or more rise in titre but no clinical evidence of infection. Study findings indicate that patients harboring C trachomatis in the cervix at abortion are at high risk of developing postoperative infections and that C trachomatis is a major etiological agent in salpingitis occurring after abortion.
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PMID:Therapeutic abortion and Chlamydia trachomatis infection. 680 51

Among 238 women who underwent first-trimester abortion and who were randomized to the placebo group in a clinical controlled trial we studied the possible correlation of the variables age, parity, number of previous spontaneous and induced abortions, previous pelvic inflammatory disease (PID), gestational age, chronic pelvic pain, dyspareunia, dysmenorrhea, social status, and the application of an intrauterine device (IUD) at abortion - to the number of days with pain, bleeding, discharge, fever, absence from work, and day of first coitus after abortion. The ANOVA test of Kruskal-Wallis with the limit of significance p less than 0.05 was employed. Women with one or more previous spontaneous abortions had significantly more days with postabortive bleeding (p = 0.010). Women with previous PID and women with dysmenorrhea had significantly more days with pain after abortion (p = 0.011 and p = 0.001). Women at a gestational age of 11-12 weeks had significantly more days with fever (p = 0.009). Women who had an IUD inserted at abortion suffered more days with pain and bleeding (p = 0.038 and p = 0.043). No one group of women carried a risk of several severe complaints after abortion except those with a history of PID.
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PMID:Risk factors in first-trimester abortion. 714 11


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