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)

Our experience with 18 patients undergoing pelvic exenteration for advanced primary or recurrent pelvic malignancies is presented. Only one postoperative death was noted, and morbidity was minimal despite the advanced age and high incidence of radiotherapy failures seen in our patients. Although no improvement in cure of malignancy has been seen in this small series, appreciable periods of symptom-free life have been achieved in patients who were previously incapacitated by extensive pelvic pain, fistulas, sepsis, hemorrhage and urinary-fecal incontinence. Because of the symptomatic palliation obtained in our experience, with minimal morbidity and mortality, we have developed a liberal attitude toward the use of pelvic exenteration in the management of selected patients with extensive pelvic malignancy, even when cure is not anticipated.
 ...
PMID:New look at pelvic exenteration. 5 61

It has been traditional to exclude patients with radiation-recurrent carcinoma of the uterine cervix or other pelvic neoplasms, incapacitating pelvic pain, postirradiation fistulas, hemorrhage, or malodorous draining tumor necrosis from pelvic exenteration if cure of the malignant disease is not achievable. This negative attitude is a direct result of the reported high morbidity, prohibitive mortality, and low salvage rate previously associated with pelvic exenteration, the only acceptable surgical approach to these diseases. A recent experience with eighteen patients who underwent pelvic exenteration for advanced primary or recurrent carcinoma of the cervix, urinary bladder, or rectum has led us to challenge several traditional concepts regarding this operative procedure. We have observed but one operative death and our morbidity has been minimal. This may reflect our belief that an aggressive pelvic lymphadenectomy in those patients with direct visceral involvement from radiation-recurrent carcinoma of the pelvic viscera is not advantageous since no significant survival has ever been documented for patients with pathologic visceral involvement and positive lymph nodes. In addition, significant morbidity has always been associated directly with pelvic lymphadenectomy in the irradiated pelvis, and elimination of this phase of the operation in selected patients with radiation-recurrent carcinoma is indicated. Moreover, the considerable decrease in morbidity and the minimal mortality observed have led us to adopt a very liberal attitude toward preoperative selection criteria, and we regularly now use pelvic exenteration not only for cure but as intentional palliation in selected patients. We strongly believe that elimination of pain, fistulas, pelvic sepsis, hemorrhage, and malodorous areas of tumor necrosis are important for improving the quality of life for both the patient and family.
 ...
PMID:Pelvic exenteration as palliation of malignant disease. 5 24

Laparoscopy was performed in 223 patients with acute pelvic pain but without a definite diagnosis. The clinically suspected diagnosis was confirmed by laparoscopy in only 57 patients (25%). Laparotomy was thus avoided in 145 patients (65%). The endoscopic findings in the three clinical entities included here are presented: tubal pregnancy, acute appendicitis or torsion of adnexal mass. This study emphasizes the poor correlation between the clinical diagnosis based on history, pelvic examination and physical signs, and the final laparoscopic findings. The value of laparoscopy in evaluation of acute pelvic disease is stressed.
 ...
PMID:The value of laparoscopy in acute pelvic pain. 12 58

The primary use of laparoscopy is as a surgical tool, with sterilizations being the overwhelming indication. The laparoscope is used less frequently as a non-surgical tool, with the major indication being for diagnosing infertility and/or amenorrhea, and for evaluation of obscure pelvic pain. There would seem to be several indications for laparoscopy that have been neglected, these being in confirming the diagnosis of acute pelvic inflammatory disease; in the evaluation of malignancies and abdominal-pelvic trauma; and the surgical treatment of pelvic pain. Lapar-The majority of these contraindications are relative, and depend soley on the laparoscopist's ability and his clinical judgment. The problems of hernias seem to have been over-emphasized. The laparoscopist should be aware of potential problems with umbilical hernia, and he probably can ignore hiatal hernias except when they are large and quite symptomatic. However, generalized abdominal peritonitis, significant hemoperitoneum with intestinal obstruction are felt by most authors to be absolute contraindications. The most frequent complications of laparoscopy involve the physoperitoneum. Except for cardiac arrest the most serious complications involve electrical burns to small bowel.
 ...
PMID:Indications, contraindications and complications of laparoscopy. 12 9

The clinical experience in diagnostic laparoscopy is dealt with under the conditions of the Department of Gynaecology and Obstetrics at Erlangen University. Among 700 cases the indications were infertility (34,4%), pelvic pain 27,4%), suspected ectopic pregnancy (7,9%), endocrinologic cases and malformations (18,9%), pelvic mass without symptoms (8,6%) and others (2,8%). The laparoscopic findings are shown. Important diagnostic clues otherwise missed were found in about half of the patients. In 122 women a laparotomy could be disregarded. One should be aware of diagnostic errors especially in ovarian tumors. Biopsy may help in assessment of ovarian function. In tumor diagnosis, however, it is rather dangerous. Difficulties of the methos (2,9%) and complications (1%) are discussed.
 ...
PMID:[Report on 700 gynaecologic cases in diagnostic laparoscopy (author's transl)]. 12 14

Over the last 1 1/2 years diagnostic laparoscopy has been performed in 135 cases and laparoscopic tubal cauterization carried out in 15 patients. Indications and the diagnostic Value of the gynecological laparoscopy are discussed. In agreement with other authors, laparoscopy is found to have a definite place for the diagnosis of the following gynecological disorders and complaints: 1. Examination of fallopian tubes in cases of infertility, diagnosis of malformations of the genital organs and of grave functional disorders of the ovaries; 2. Possible ectopic pregnancy; 3. Differential diagnosis of pelvic mass; 4. Evaluation of chronic pelvic pain; 5. Differential diagnosis of acute diseases of pelvic and lower abdominal organs. Histological examinations of coagulated human fallopian tubes yielded information on the mechanism of action of this modern method of sterilization.
 ...
PMID:[Position and significance of gynecologic laparoscopy]. 13 Jul 59

Laproscopic sterilization techniques and the diagnostic use of laparoscopy are discussed. In a series of 1000 laparoscopic sterilizations by the 2-incision technique, there was a total failure rate, surgical and operative, of .4%. In a similar series with the 1-incision technique and electrocagulation only, the total failure rate was 1.6%, though the complication rate was considerably reduced. The high failure rate was attributed to incomplete transection resulting in recanalization. The failure rate with a single-incision, 3-burn technique was .25% in a series of 2000 patients, and complications were few. Tubal occlusion with hemoclips has produced poor results (failure rate: 8-27%). The results with silastic bands, however, have been comparable to those for electrocoagulation, but with fewer complications. Means by which the cost of laparoscopic equipment may be reduced are discussed. Laparoscopy can be helpful in the diagnosis of infertility-endocrinology, ectopic pregnancy, pelvic pain, pelvic inflammatory disease, adnexal masses, and the retrieval of foreign bodies in the pelvic region. Contraindications to laparoscopy are reviewed. It is concluded that laparoscopy is a safe and effective means of sterilization on an outpatient basis, and is of value in the diagnosis of gynecologic disorders.
 ...
PMID:Laparoscopy. 13 20

Gynecological laparoscopic experience in a large private practice is described. Of 979 patients thus treated there have been no pregnancies. Laparoscopy has also been used to diagnose pelvic pain and abnormalities in the uterus. It has had its place in evaluating the infertile female for tubal patency. Liver biopsies can be performed by this method. This series reports the use of a double-puncture approach. Anesthesia is by Sodium Pentathol, iv muscle relaxants, oxygen and nitrous oxide. The patient is insufflanted with carbon dioxide and the pelvic cavity visualized through the laparoscope placed in the abdomen in the infra umbilical fold area. A 2nd incision is made above the pubic hairline. The tubes may either be coagulated at the cornua of the uterus and again 1.5 cm lateral to this, or coagulated and divided. Laparoscopy is an invaluable technique. It is a complicated, potentially dangerous procedure that should only be used by experienced operators.
 ...
PMID:Gynecological laparoscopy in a large private practice. 13 39

2000 laparoscopies were performed between 1968 and 1975. 253 from 493 patients with unexplained pelvic pain were followed up a half till 5 years after laparoscopy concerning the pains. The discrepancy of clinical diagnosis and laparoscopie statement is compared and discussed. The most clinical diagnosis were: chronic pelvic pain (149 cases) and unexplained pelvic pain (32 cases). Postlaparoscopic findings were: inconspicuous statements (27,3%), pelvic adhesions (27,3%), chronic disease of the fallopian tubes (21,1%), chronic appendix diseases (10,3%), ovary cysts (9,8%), endometriosis (4,3%).52,9% of the patients were cured by specific treatment a half till 5 years after laparoscopy. The laparoscopy is considered to be a diagnostic and therapeutic acurate method. 14,2% of the patients with little or inconspicuous statements were cured after instruction. The laparoscopy may be the base for acurate diagnostic and team-work of several branches of knowledge.
 ...
PMID:[Chronic lower abdominal complaints in the woman - a postlaparoscopic analysis]. 13 21

The authors performed 2000 laparoscopies in females with chronic and acute pelvic pain. In 399 cases an appendectomy had been done before. Among 478 patients with acute pelvic pain an acute appendicitis was found in 26 women by laparoscopy.
 ...
PMID:[Acute and chronic appendicitis; gynaecologic laparoscopy (author's transl)]. 14 4


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