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)

The authors -- about a series of 124 cancerous patients treated during the 12 last years with open spino-thalamic cordotomy for intractable pain -- have tried to evaluate effectiveness of the operation with regard to its levels in relation to the site of pain. Patients suffering median or bilateral perineo-pelvic pain, isolated or associated with algias in one or both legs (group I: 50%) underwent a bilateral C8-C6 cordotomy in one stage. Patients with the same perineo-pelvic cancers but suffering only unilateral pain (group II : 31,8%) and patients with painful cancers in the leg (group III : 3,2%), were operated on with a C7 controlateral cordotomy. Patients suffering widespread unilateral pain in the chest, isolated or associated with algias in the arm, for instance from lung or breast cancers (group IV : 15%) underwent a controlateral C2 cordotomy. There was 3,2% mortality and one paraplegia. A useful early effect(i.e. complete or partial relief) was obtained : in 85% cases (60% and 25%) for the 1st group, in only 51% (36% and 15%) for the 2nd, and in 87% (56% and 31%) for the 4th. Relief was complete in each of the 4 cases of the 3rd group. In the 2nd group 39% of patients were completely relieved of their initial unilateral pain, but complained of an early post-operative pain on the other side. This secondary pain was supposed existing prior to the operation, but masked because of its lesser intensity. The useful results at the time of death, after a 6 month mean survival (from 1 month to 4 years), were 63,75% in the 1st group, 33% in the 2nd, 100% in the 3rd and 72% in the 4th. The high rate of poor results with unilateral cervical cordotomy in the perineo-pelvic cancers with apparently unilateral pain, led us since then to systematically perform for them a bilateral cordotomy. Thus, our general management for pain of malignant origin is now as follows: C8-C6 bilateral cordotomy for all the perineo-pelvic cancers whatever uni- or bilateral the site of pain may be; C7 controlateral cordotomy for the painful cancers of the leg; and C2 controlateral cordotomy for hemithoracic and/or arm pain, when related to very extended lung or breast cancers. We prefer complete posterior rhizotomy for limited cancers of the thoracic wall, and selective posterior rhizotomy through the scope, from -- the brachial plexus roots down to T4 -- for pain as from the PANCOAST-TOBIAS syndromes, or in case of painful involvements of the upper limb roots. For cervico-facial cancers we generally use combined sections of the sensory cranial nerves in the posterior fossa and of the cervical posterior roots.
 ...
PMID:[Spino-thalamic cordotomy in cancerous pain. Results of a series of 124 patients operated on by the direct posterior approach]. 107 Nov 36

Three cases of coccidioidomycosis of the female genital tract are reviewed. The diagnosis was made by laparotomy in 2 patients who presented with tender adnexal masses, and by endometrical curettage in a third patient with disseminated coccidioidomycosis. Hysterectomies were performed in all 3 patients; 1 had a bilateral salpingo-oophorectomy and the others a bilteral salpingectomy and unilateral oophorectomy. Two patients received chemotherapy with amphotericin B. One patient died 4 years after her operation from disseminated and meningeal coccidioidomycosis. In a female patient who has resided in an endemic region and who presents with pelvic pain of obscure origin, unexplained infertility, a menstrual disorder, or a chronic, refractory pelvic inflammatory disease, genital coccidioidomycosis should be considered in the differential diagnosis.
 ...
PMID:Female genital coccidioidomycosis. 111 94

Prior to an abdominal operation, 125 patients were asked if they regularly had headache during the menstrual period together with or without pain in the lower pelvic region. Pelvic pain patients with endometriosis externa reported headache significantly more often than those without endometriosis. Headache proved to be almost as common a symptom as lower pelvic pain in patients with endometriosis.
 ...
PMID:Headache as a symptom of endometriosis externa. 119 Jun 95

Previous reports have demonstrated a significant incidence of pelvic symptomatology involving ovaries preserved following hysterectomy, to be called "the residual ovary syndrome." This report, in an 11-year retrospective analysis of all oophorectomies at The Methodist Hospital in Houston, Texas, identified 202 cases in which a previous hysterectomy had been performed. The majority of these patients presented with varying degrees of chronic pelvic pain (77.2%), asymptomatic pelvic mass (14.4%), and dyspareunia (67.0%). The incidence of malignant neoplastic change in these patients was 3.0%, related to whether hysterectomy was performed before or after the age of 40. In view of the incidence of the residual ovary syndrome and the risk of malignant neoplastic change when hysterectomy is performed after the age of 40, serious consideration of total ovarian ablation at the time of hysterectomy should be weighed against any temporary physiologic and/or psychologic benefits to be gained from conservation.
 ...
PMID:The residual ovary syndrome. 119 57

In 100 women who underwent laparoscopic sterilization approximately one year before a follow-up check including gynecological examination, a structurized interview and a "Maudsley Personality Inventory" (MPI) test were performed. 6% complained about algopareunia before the operation which did not disappear afterwards. In 8 patients algopareunia started after the operation, only 2 of them presenting pelvic adhesions at control, whereas 6 patients suffered from psychogenic algopareunia. Neurotic tendency was evidently elevated in all those patients complaining about pelvic pain before and after operation. 6 patients had pelvipathia nervosa, 14 showed organic alterations, but these were not necessarily the reason for the complaints. Laparoscopy revealed pathologic processes e.g. adhesions, pelvic varicosis or adnexitis in 27%, but not more than 11% of these patients with obvious pathology had subjective complaints. These findings underline the fact that pathologic alterations will not necessarily explain pelvic pains and that in most cases psychosomatic factors must be taken into consideration.
 ...
PMID:[Organic changes and pain after laparoscopic tubal sterilization]. 124 Aug 36

Data are presented for 7 women, each having two IUDs in utero. Five of these patients developed symptoms of abnormal bleeding and/or pelvic pain and 2 were asymptomatic. Three women had received the second IUD because it was assumed the first one had been expelled when the filaments were no longer palpable or visible. Other causes, as well as the prevention, diagnosis, and potential danger of this complication, are discussed.
 ...
PMID:Accidental insertion of multiple IUDs. 125 May 67

Endometriosis is a common finding at laparoscopy. In order to make a correct diagnosis and institute appropriate management it is recommended that laparoscopy be performed on all patients with chronic pelvic pain and on most patients with infertility or acute pelvic pain.
 ...
PMID:Incidence of endometriosis in diagnostic laparoscopy. 125 48

The patient with chronic pelvic pain represents a real challenge to the physician. The challenge is not primarily to relieve the pain, but to form a relationship with the patient and to try to learn about and help her with psychosocial distress. In this process the physician must use himself or herself as a human instrument to try to relieve suffering in the global aspect of the word.
 ...
PMID:Psychological aspects of chronic pelvic pain. 127 11

We report on 4 patients with persistent, severe pelvic pain unresponsive to removal of the bladder, uterus, ovaries and fallopian tubes. Of the patients 3 had a diagnosis of interstitial cystitis and 1 had voiding dysfunction. We conclude that severe pelvic pain may not be responsive to the elimination of pelvic organs and alternative organ-preserving therapies should be considered.
 ...
PMID:Pelvic pain without pelvic organs. 140 52

Dorsal root entry zone (DREZ) lesions are effective in treating specific pain syndromes, most notably post-brachial plexus avulsion. There is limited experience, however, with lesions in the conus medullaris. We review the case of a patient having pelvic pain and urinary retention who failed to improve despite multiple prior interventions. Her pain was completely relieved after DREZ lesions were placed bilaterally at S2, S3, S4 and S5. The intraoperative sensory and motor evoked potential monitoring used to define the level is described in detail.
 ...
PMID:Relief from chronic pelvic pain through surgical lesions of the conus medullaris dorsal root entry zone. 129 50


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