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)

Compared with transabdominal pelvic ultrasonography, transvaginal ultrasonography provides improved resolution for visualization of female pelvic organs, with less artifact. Transvaginal ultrasonography has superseded the transabdominal approach in many situations. Identification of uterine and adnexal masses can be facilitated with use of transvaginal ultrasonography. Transvaginal ultrasonography is also useful in the evaluation of pelvic pain and suspected pelvic inflammatory disease. Postmenopausal patients with vaginal bleeding or a palpable ovary can be triaged on the basis of transvaginal ultrasonographic findings, avoiding invasive diagnostic procedures in selected patients. Screening average-risk patients for ovarian cancer is not an accepted indication for transvaginal ultrasonography at this time.
 ...
PMID:Transvaginal ultrasonography in nonpregnant and postmenopausal women. 862 19

Pelvic inflammatory disease (PID) results from an ascending polymicrobial infection of unclear pathogenesis. One in 10 women in the United States has PID during her reproductive years. Medical costs of managing the disease and its sequelae are over $5 billion per year. One out of four women with PID has serious sequelae, including infertility, ectopic pregnancy or chronic pelvic pain. Patients with PID present with a spectrum of clinical symptoms and signs, none of which conclusively makes the diagnosis. The diagnosis of PID relies on a high index of suspicion, coupled with empiric therapeutic intervention and careful follow-up. Revised guidelines from the Centers for Disease Control and Prevention include recommendations for the use of broad-spectrum antibiotics, which are initiated before culture results are obtained. Indications for hospitalization are more liberal now than under the previous CDC recommendations. Prompt recognition, patient compliance with recommended therapy and treatment of the sexual partner decrease the risk of sequelae. Family physicians can make significant contributions to the health care of women through skillful management of PID.
 ...
PMID:Pelvic inflammatory disease: a contemporary approach. 862 62

We evaluated the outcome of microsurgical (n = 72) and laparoscopic (n = 51) adhesiolysis in women who complained of chronic pelvic pain. Adhesion severity was not significantly different between the two treatment groups. The influences of the following variables on the outcome of all 123 cases of adhesiolysis were examined: (i) surgical modality (microsurgical or laparoscopic), (ii) history of infertility, (iii) associated dyspareunia and (iv) aetiological factors of adhesive disease (endometriosis, pelvic inflammatory disease and previous laparotomy). To adjust for differences in follow-up intervals, overall and subgroup cumulative rates of pain persistence/recurrence were calculated and compared. To adjust for interrelationships between variables and to correct fo differences between the treatment groups, a proportional hazards regression analysis was employed. This analysis showed that the cumulative rate of pain persistance/recurrence at 24 months was not significantly different after microsurgical (44%) and laparoscopic (53%) adhesiolysis. From all the variables which were examined, the only one which appeared to influence the impact of surgical adhesiolysis for chronic pelvic pain was a history of previous laparotomy. A history of previous laparotomy was associated with approximately three times higher rates of pain persistence or recurrence. This effect did not depend on whether previous laparotomy was carried out for pain or for other indications. The most likely explanation for the failure of these patients who had a previous laparotomy to respond to surgery is that they intrinsically have a higher rate of adhesion formation and reformation. This can only be confirmed with a prospective study where all patients will undergo a second-look laparoscopy.
 ...
PMID:An analysis of the outcome of microsurgical and laparoscopic adhesiolysis for chronic pelvic pain. 874 39

Infections caused by Chlamydia trachomatis are probably the most common sexually transmitted diseases in the United States. Commonly unrecognized and often inadequately treated, chlamydial infections can ascend the reproductive tract and cause pelvic inflammatory disease, which often results in the devastating consequences of infertility, ectopic pregnancy, or chronic pelvic pain. C. trachomatis infections are also known to increase the risk for human immunodeficiency virus infection. The obligate intracellular life cycle of C. trachomatis has traditionally required laboratory diagnostic tests that are technically demanding, labor-intensive, expensive, and difficult to access. In spite of these historical challenges, however, laboratory diagnosis of C. trachomatis has been a rapidly advancing area in which there is presently a wide array of commercial diagnostic technologies, costs, manufacturers. This review describes and compares the diagnostic methods for C. trachomatis infection that are currently approved for use in the United States, including the newest DNA amplification technologies which are yet to be licensed for commercial use. Issues to consider in selecting a test for purposes of screening versus diagnosis based on prevalence, performance, legal, social, and cost issues are also discussed.
 ...
PMID:Current methods of laboratory diagnosis of Chlamydia trachomatis infections. 945 34

Hysterectomy is the commonest major operation performed by gynaecologists and is the definitive cure for many of it's indications which include dysfunctional uterine bleeding, fibroids, utero-vaginal prolapse, endometriosis and adenomyosis, pelvic inflammatory disease, pelvic pain, gynaecological cancers and obstetric complications. It is a successful operation in terms of relieving women of their presenting symptoms and high levels of satisfaction are reported by patients. However, it has a high risk of complications, involves a prolonged convalescence, is expensive and to some women represents a loss of femininity. It should only be employed after trying conservative treatments first if appropriate. If this fails, currently only endometrial ablation and myomectomy are valid alternatives to hysterectomy. If ultimately hysterectomy is required, there is considerable evidence that patient care can be improved by increasing the proportion of operations that are done vaginally and laparoscopically and decreasing the number of laparotomies.
 ...
PMID:Indications and alternatives to hysterectomy. 915 36

Tuboovarian abscess is a serious consequence of pelvic inflammatory disease, especially in the adolescent population. Early diagnosis and treatment are essential to prevent further sequelae including infertility, ectopic pregnancy, and chronic pelvic pain. Not all patients, however, present with pelvic pain, pelvic mass, fever, and leukocytosis. We present the case of a sexually active 15-year-old black girl who presented with mild abdominal pain and excessive vaginal bleeding without pelvic mass, fever, or leukocytosis. Erythrocyte sedimentation rate was 66 mm/h. Pelvic ultrasound revealed bilateral complex ovarian masses. At laparoscopy, the patient had bilateral tuboovarian abscesses with extensive adhesions to the pelvic side walls. This case illustrates the need for a high index of suspicion of tuboovarian abscess in sexually active adolescents.
 ...
PMID:Tuboovarian abscess in the adolescent. 917 5

Pelvic inflammatory disease (PID) is a common and poorly managed condition. Untreated or inadequately treated, it leads to tubal infertility, ectopic pregnancy and chronic pelvic pain. Diagnostic difficulties are compounded by the wide variety of clinical presentations and the insensitivity and poor specificity of laboratory tests. Better recognition of mild and atypical disease needs a high index of suspicion whenever young, sexually active women present with gynaecological symptoms. Laparoscopy supplemented by microbiological tests and fimbrial minibiopsy should be regarded as the diagnostic 'gold standard' for research studies; new studies are required to identify techniques which might reduce under- and over-diagnosis. Early treatment reduces the risk of an adverse effect on fertility. Any therapeutic regimen selected should be effective against the common aetiological agents Chlamydia trachomatis, Neisseria gonorrhoeae, genital mycoplasmas and aerobic and anaerobic bacteria. Since at least 60% of cases of PID can be attributed to infection with a sexually transmitted organism, partner notification forms an essential part of management.
 ...
PMID:Clinical aspects of pelvic inflammatory disease. 943 68

Pelvic inflammatory disease (PID), an infection of the female genital tract, presents a number of difficult challenges in diagnosis and management. Adolescents in particular require aggressive care of PID to prevent the long-term sequelae of chronic pelvic pain and infertility. This article reviews the etiology, microbiology, diagnosis, and management of PID, with an emphasis on treating adolescents with PID.
 ...
PMID:Pelvic inflammatory disease: the importance of aggressive treatment in adolescents. 967 92

Menstrual problems and side effects associated with long-term Copper T 380A use in perimenopausal women were investigated in a follow-up study of 50 Thai women who had the IUD inserted after 40 years of age (average, 44.2 years) and used the device for at least 36 months. All study participants had their IUD inserted at the family planning clinic of the Faculty of Medicine, Chulalongkorn University, in Bangkok, Thailand, and were followed at 6-month intervals. Their average parity was 2 live births. The numbers of women with irregular menstrual cycles at 12, 24, and 36 months after IUD insertion were 7 (14%), 11 (22%), and 15 (30%), respectively. Intermenstrual bleeding and pelvic pain--the most common side effects--were experienced by 15 (30%) and 9 (18%) women, respectively, during 36 months of follow up. No pregnancies, pelvic inflammatory disease, or IUD expulsions occurred and there were no significant changes in body weight or blood pressure. These findings suggest that TCu 380A use is both safe and effective up to menopause.
 ...
PMID:Menstrual problems and side effects associated with long-term TCu 380A IUD use in perimenopausal women. 969 3

Ovarian remnants occur after a portion of ovarian tissue is left behind unintentionally after oophorectomy. The ovarian remnant may be functional and cystic, producing pelvic pain and, in some patients, extrinsic compression of the distal ureter. Ovarian remnants frequently are associated with adhesions from previous pelvic surgery for endometriosis or pelvic inflammatory disease. Ovarian remnants also may be included within pelvic peritoneal inclusion cysts. In this retrospective study, the sonographic features of ovarian remnants in 10 patients with surgical proof or clinical follow-up data are described. Most ovarian remnants were simple cysts (seven of 10), three had multiple septations, and six had a rim of presumably ovarian tissue with arterial and venous flow. Three patients with ovarian remnant masses that were aspirated had symptomatic relief without recurrence. In one patient, guided aspiration was unsuccessful, probably owing to the presence of organized hemorrhage within the mass. Extrinsic compression of the distal ureter was observed in one patient, who was treated with gonadotropin releasing hormone agonist (Lupron). The sonographic findings of a completely cystic or multiseptated pelvic mass with a rim of vascularized solid tissue in a postoophorectomy patient, although such cases are rare, suggest the diagnosis of an ovarian remnant. If the diagnosis can be established with a high degree of certainty, sonographically guided aspiration may be attempted in an effort to provide symptomatic relief. Otherwise, sonography is useful in serial assessment of these masses in patients receiving medical treatment.
 ...
PMID:Sonographic features of ovarian remnants. 973 72


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>