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

There are few studies from family practice offices summarizing experience with culture-proven gonorrhea. Seventy-nine such cases were identified over a six-year period in a family practice model office in Gainesville, Florida, a rate of 5.8 cases per 10,000 patient visits. Ninety-six percent of the patients in the study had limited financial resources by insurance classification. The most commonly recognized presentations in men were complaints of discharge or dysuria or both. Nine (15%) of the women gave a history of contact with a person said to have a sexually transmitted disease, but none of the men did. Of the 62 women, gonorrhea was found on routine cervical culture in only two (3%), 38 (61%) had pelvic pain, and 40 (65%) had discharge as an initial complaint. Fifty-one of the patients (88%) reported symptomatic improvement with treatment, and seven (12%) reported no improvement by the treatment. Post-treatment gonorrhea cultures were positive in two (3%), negative in thirty-three (42%), not done in seventeen (22%), and twenty-seven of the patients (34%) did not return for scheduled follow-up. Difficulties in treating patients with gonorrhea in this population appeared to be largely related to problems with patient follow-up.
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PMID:Gonorrhea care in a clinic for low-income patients. 205 12

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

Fifty patients with intractable pain, mainly of neoplastic origin, were treated by morphine through unidose drug delivery system. Criteria of selection of the patients and technical procedures are reported. Most common side effects are nausea and dysuria but can be effectively prevented. The most severe complications are leakage of cerebro spinal fluid with or without meningitis. The success rate at 20 days is 80% as well in pelvic pain as in subdiaphragmatic extra cephalic pain.
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PMID:[Intrathecal analgesia. Apropos of 50 cases]. 318 49

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

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

This study assessed whether hysteroscopy can provide information concerning the cause of chronic pelvic pain. We prospectively evaluated the findings in 547 consecutive patients who had laparoscopy to evaluate chronic pelvic pain at a large, referral-based clinic and outpatient suite of a suburban hospital. Forty-eight had previous hysterectomies. The remaining 499 had hysteroscopy during the same surgery and met the following qualifications: chronic pelvic pain, dysmenorrhea, dyspareunia, dysuria, back pain, pelvic pressure or dyschezia for a duration greater than six months and previous failed medical therapy. When endometriosis was the primary diagnosis at laparoscopy, hysteroscopy revealed abnormalities in 62 (32.5%) of 191 patients. At hysteroscopy, 46 of 105 patients (43.8%) with single or multiple leiomyomas of significant sizes diagnosed laparoscopically were noted to have pathology within the uterine cavity. Ten of 11 patients (90.9%) found to have ovarian cysts underwent hysteroscopy. Four (40%) had uterine abnormalities; the most common was cervical stenosis. Pelvic adhesions were found in 118 patients (21.6%). Eighty-nine underwent hysteroscopy, and 24 (27%) had intrauterine abnormalities. Ninety-six patients (17.5%) who underwent laparoscopic evaluation had endometriosis and pelvic adhesions. Ninety-three of these underwent hysteroscopy, and abnormalities were noted in 26 (28.0%). In eight women (1.5%) no abnormality was found at laparoscopy. Two underwent hysteroscopy, and no abnormality was noted in either woman. Hysteroscopy provides useful, adjunctive information and may improve the diagnosis and treatment of chronic pelvic pain.
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PMID:Use of hysteroscopy in addition to laparoscopy for evaluating chronic pelvic pain. 765 Jun 54

There is a wide variety of pathologies associated with the presence of urachal remnants. We describe a case of infected urachal cyst in a young adult male, with classical symptoms of dysuria, lower abdominal pain, and fever. Ultrasound, cystography and CT are described, ultrasound being often the modality of choice. Differential diagnosis of acute abdominal and pelvic pain or a midline lower abdominal mass at this age should include infection of an urachal remnant.
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PMID:[Infected urachal cyst]. 832 Jan 87

A case is reported of the presence of an intrauterine device into the bladder due to uterine perforation with calculus formation in a 39 year old woman, with two pregnancies after its installation. The patient was seen for complaints of pelvic pain, pollakiuria, dysuria and tenesmus, without uterine sintomatology. The case was studied in July of 1993 in the General Hospital "Vicente Guerrero" of Acapulco. To our knowledge only 19 previous cases have been reported in the literature of migration of an intrauterine device into the bladder with calculus formation. The literature is reviewed and we discuss the clinico-radiological findings.
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PMID:[Uterine perforation and localization of an IUD in the bladder associated with bladder calculosis. Report of a case and review of the literature]. 854 21

Interstitial cystitis (IC) is a poorly understood syndrome. Patients with pelvic pain, urgency, frequency, and/or dysuria may pose a diagnostic dilemma. They may have bladder-related symptoms or they may have nonbladder related symptoms. It is beneficial for the urologist to distinguish between these patients. This study outlined a modified urodynamics test to discriminate between bladder-related and nonbladder-related patients. Consecutive IC patients (bladder-related and nonbladder-related patients) and stress incontinent controls underwent modified urodynamics. Testing consisted of an epithelial leak test, a filling cystometrogram, bladder emptying and instilling lidocaine intravesically, and repeat cystometrogram after bladder emptying. The epithelial leak test and lidocaine test predict reliably if a patient has bladder-related or nonbladder-related symptoms. Modified urodynamics permits a logical stratification of IC patients, and may predict treatment response.
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PMID:Modified urodynamics for interstitial cystitis. 929 63

To assess the morbidity of S. haematobium infection in women of reproductive age (15-49 years) in the western part of Madagascar, the village of Betalatala with a prevalence of urinary schistosomiasis in women of 75.6% (95% confidence limit 69.3 to 81.9%) was compared with a neighbouring village with similar socio-economic characteristics and a prevalence of 5.0% (95% confidence limit 0 to 11.75%). The women were questioned in Malagasy about obstetrical history and urogynecological symptoms. They were examined gynaecologically, parasitologically and by ultrasonography. Important STDs were excluded by appropriate diagnostics. In Betalatala significantly more women reported a history of spontaneous abortion (P < 0.01), complaints of irregular menstruation (P < 0.001), pelvic pain (<0.05), vaginal discharge (P < 0.0001), dysuria (P < 0.05) and haematuria (P < 0.01) than in the control village. Biopsies were obtained from the cervix of 36 women with macroscopical lesions, and in 12 cases S. haematobium eggs were found by histological sectioning (33.3%). In the control village no eggs were detected in the histological sections of biopsies taken from 14 women. (P < 0.05). Infections with Candida albicans, Trichomonas vaginalis, Gardnerella vaginalis and Treponema pallidum were found in similar frequencies in both villages. In 9.8% of the women in Betalatala abnormalities of the upper reproductive tract were revealed by ultrasonography versus none in the women from the control village (P < 0.05). Echographic abnormalities of the urinary tract were present in 24% and 3% of the women in the study village and in the control village, respectively (P < 0.0001). These findings were accompanied by an elevated frequency of haematuria (55% versus 20%) and proteinuria (70.4% versus 25%) in the study population (P < 0.0001). Our study indicates that S. haematobium infection in women may not only cause symptoms in the urinary tract, but also frequently in the lower and upper reproductive tract.
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PMID:Clinical findings in female genital schistosomiasis in Madagascar. 962 35


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