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)

Complaints of abdominal and pelvic pain account for a large number of Emergency Department presentations. Unfortunately, the subjective, often ambiguous, complaint of pain may represent a broad spectrum of pathology ranging from relatively benign disorders to acute, life-threatening illness. It is the duty of the Emergency Department physician to separate the potentially lethal disorders from the less acute illnesses, a task that this article aims to make easier.
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PMID:Abdominal and pelvic pain. 365 19

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

Over an eight-year period, 50 presacral neurectomies were performed at Madigan Army Medical Center for chronic pelvic pain failing response to medical management. Each hospital record was reviewed and 45 patients answered a questionnaire grading the severity of their pain from 0 to 10 for dysmenorrhea, dyspareunia, and other pelvic pain before and after surgery. The results showed success rates of 73% in relieving dysmenorrhea, 77% in relieving dyspareunia, and 63% in relieving other pelvic pains. The addition of a bilateral uterosacral ligament resection to the presacral neurectomy did not increase the success rate. There was an 18% lateral pelvic pain recurrence rate, and no recurrence of dysmenorrhea. Complications occurred in 4%.
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PMID:Presacral neurectomy for chronic pelvic pain. 374 2

Sixty women using IUDs were included in two equal groups in the present study. Group I consisted of women presenting with pelvic pain for which they requested removal of the IUD, while the comparison group (group II) requested removal of the IUD for non-medical reasons. After extraction of the IUD, the Wing Sound II device was used to measure uterine cavity length and fundal transverse diameter. The uterine cavity measurements in both groups were not significantly different. When the ratios of IUD dimensions to uterine cavity measurements were compared, it was also found that there were no significant differences between groups. Factors other than discrepancies in size probably contribute to the pathogenesis of IUD-induced pain.
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PMID:Uterine geometry and IUD-induced pain. 377 43

In the period 1979-1983, 102 patients with endometriosis underwent conservative surgery at Ia Clinica Ostetrica e Ginecologica, Milan University. Treatment indications, techniques and results are presented. 34.3% of the women were in stage I, 51% in stage II and 14.7% in stage III of the American Fertility Society classification. Postoperatively, the incidence of dysmenorrhea fell from 63.7% to 15.7%, deep dyspareunia from 53.3% to 17.6% and chronic pelvic pain 21.6% to 11.8%. In 1-6 years' follow-up of the 53 women wanting children, the postoperative birth-rate was 68.3% in stage I patients, 59% in stage II and 37.5% in stage III. Endometriosis treatment is still only symptomatic, and conservative surgery, using atraumatic procedures, should aim at restoring fertility and resolving pain symptomatology.
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PMID:Conservative surgical treatment of endometriosis. 378 26

Twenty cancer patients with severe chronic pain have been treated with intraventricular morphine sulfate. Adequate pain relief until death was achieved in 10 patients; 1 patient has been treated for 9 months and is still being treated. In 2 patients, the effects of the morphine sulfate on their unilateral pelvic pain wore off after 4 and 6 months because of tumor progression. At that time, they underwent chordotomy procedures elsewhere. The treatment was discontinued in 4 patients for reasons other than inadequate pain relief, such as medical complications or resolution of pain. In 3 patients, the procedure was abandoned when emotional and psychological factors interfered with pain control. Dose requirements of intraventricular morphine sulfate varied greatly, depending on the total daily dose of systemic narcotic intake at the onset of the study. Intraventricular morphine sulfate is a feasible and reliable method to achieve pain relief in selected cancer patients with severe chronic pain when the maximum tolerated dose of systemic narcotic analgesics has become insufficient to control their pain.
Pain 1987 Jan
PMID:Intraventricular morphine administration for control of chronic cancer pain. 382 95

This study evaluated the effectiveness, safety, and acceptability of the TCu 380Ag and the Multiload Cu375 IUDs in a multicenter international trial involving 1499 acceptors. The 2 devices were randomly assigned to women who entered the trial at 5 centers in Yugoslavis, Panama, Costa Rica, and Egypt between September 1980 and June 1982. The median age of the 737 women in the TCu 380Ag group was 26.7 years, with an average parity of 1.8; the median age of the 740 women in the Multiload Cu375 group was 27.5 years, with an average parity of 1.9. At insertion, 6.8% of women in the TCu 380Ag group and 6.2% of those in the Multiload Cu375 group complained of mild pain, 1.1% of women in both groups reported moderate pain, and there were no reports of severe pain. 1-year bleeding and pain removal rates were 3.8; removal rates for other medical reasons were less than 1.0/100 women. Significantly more women in the TCu 380Ag group reported intermenstrual pelvic pain, but this difference was confined to women under 30 years of age. The continuation rate at 1 year was 90.9% for the TCu 380Ag group and 88.7% for the Multiload Cu375 group. These rates are considerably higher than those reported for other IUDs. Of the 7 pregnancies reported in the 1st year after insertion, 2 occurred in the Tcu 380Ag group and 5 occurred in the Multiload Cu375 group. The results from this trial suggest that both the TCu 380Ag and Multiload Cu375 IUDs provide a highly effective, safe, and acceptable method of contraception. For women who wish to achieve contraceptive effectiveness for long periods, the TCu 380Ag may be the IUD of choice. It remains effective for 10-15 years, while the Multiload Cu375 has a life span of only 3-5 years.
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PMID:An evaluation of the TCu 380Ag and the Multiload Cu375. 388 Dec 95

Nine patients who had chronic perineal sinuses following proctectomy for inflammatory bowel disease underwent wide excision of the sinus and split-thickness skin grafting. All patients had persistent pain and discharge. All but one had undergone multiple surgical procedures previously. Fibrous tissue was excised from the sinus tract and the wound was grafted either immediately (six patients) or at a later date (three patients). Five patients had complete healing of the wound initially while four required further procedures. Eight patients have been followed up for an average of 4.6 years (range from 5 months to 12 years). Complete healing was achieved in seven patients; all are free of pain and can work or are unrestricted in their daily activities. One patient is improved but still requires analgesia and is disabled by the persistent pelvic pain.
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PMID:Management of chronic perineal sinuses by wide excision and split-thickness skin grafting. 389 66

Thirty patients with unresectable pelvic tumors from recurrent or metastatic colorectal cancer, after failing all conventional chemotherapy or radiotherapy, were treated with mitomycin C (MMC) regional intra-arterial (IA) infusion. MMC at a dose of 20 mg/m2 in 100 mL of 5% dextrose in water was infused for a one-hour period through the regional artery (eg, hypogastric, gluteal) approached percutaneously via the femoral artery. This treatment was repeated every four to eight weeks. Of the 26 patients who could be evaluated, three had objective responses, 14 had tumor stabilization, and nine had no response. Median survival time for the responders (Rs) was 435 days, for stabilized patients (Ss) was 263 days, and for nonresponders (NRs) was 195 days, giving an overall survival time of 239 days. Fourteen patients (2 Rs, 8 Ss, and 4 NRs) had good relief of pain after the IA infusion. Thirty-three pelvic arteriograms (including three patients who had never received IA infusion) showed an avascular tumor of grade 0 in eight patients, a hypovascular tumor of grades 1 and 2 in 16 patients, and a vascular tumor of grade 3 in nine patients. Neovasculatures were mainly derived from the hypogastric artery or its branches (eg, gluteal, obturator, and pudendal artery), and occasionally were found to be derived from the superior hemorrhoidal, lumbar, and sacral arteries. The major side effect after the pelvic infusion was necrotizing cellulitis occurring in the buttock. Myelosuppression was manageable and other toxic effects were mild. Metastatic colorectal cancer occurring in the pelvis was basically a vascular-deficient tumor. Regional IA MMC infusion given intermittently was found effective in palliating pelvic pain and improving the quality of these patients' lives.
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PMID:Pelvic intra-arterial mitomycin C infusion in previously treated patients with metastatic, unresectable, pelvic colorectal cancer and angiographic determination of tumor vascularity. 392 59

A pilot study was conducted, in which photodynamic therapy (PDT), a technique in which malignant cells are destroyed by light after being previously photosensitized by a chemical compound, was tried in a group of 14 patients with recurrent or residual colorectal cancer in the pelvis. Three of the six patients with unresectable pelvic recurrences experienced a significant relief of pain after PDT. In two of the five patients who had an incomplete resection of their pelvic recurrences, there was also a substantial relief of pelvic pain after surgery and PDT. In one of these patients subsequent biopsies proved the disappearance of the residual pelvic microscopic disease after several sessions of PDT. Three patients had a recurrence from a squamous cell carcinoma primary of the anal canal. All recurrences were amenable to surgical resection. In one of the patients, PDT was used in an attempt to sterilize an area of residual tumor that was located over the left ischial tuberosity. The patient experienced good relief of pain, but died of her disease 7 months after PDT. In the other two patients, PDT was used as an "adjunct" after resection of their recurrences. One of these patients was free of disease and died of an unrelated cause 12 months after PDT. The other is alive and well. This study demonstrated that PDT can be safe and tolerable in patients with pelvic malignancies. PDT is capable of tumor destruction, can be used repeatedly in areas previously exposed to ionizing radiation, and may have a role in the prevention and management of pelvic-perineal recurrences from colorectal cancer.
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PMID:Photodynamic therapy in patients with colorectal cancer. 394 6


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