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

Ketoprofen and indomethacin were compared as specific therapies for primary dysmenorrhea in this study involving 23 primary dysmenorrheic women; the study was double-blind and cross-over. Each patient was given a code-numbered package of capsules of ketoprofen (50 mg) or indomethacin (25 mg); medication (1 capsule 3 times daily) was started 1 day before menstruation and was continued until cessation of dysmenorrheic symptoms (no longer than 4 days). Patient estimation of the effect of ketoprofen was ranked as good in 70% of cases, moderate in 18%, and nil in 12%. For indomethacin, the figures were 58, 31, and 10%, respectively. Initial dysmenorrhea score of 9.6 was reduced to 3.6 during ketoprofen therapy and to 4 with indomethacin (P.001). Ketoprofen alleviated pelvic pain in 84% of cases; indomethacin in 78%. Mean duration of pelvic pain was reduced to 5.1 hours from an initial period of 10.6 hours with ketoprofen and 5 hours with indomethacin (P.01); this statistic excluded cycles of total relief. Other symptoms relieved were similar with both drugs, including: lower back pain, vomiting, diarrhea, and dizziness (alleviated in 82-97%) and headache, fatigue, and nervousness (alleviated in 40-67%). Blood loss was subjectively estimated to decrease in 42% and increase in 4% of ketoprofen-treated patients, whereas for indomethacin these figures were 36% and 7%, respectively. All side effects were mild. The rate of lost working days was significantly decreased under both treatments.
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PMID:The refief of primary dysmenorrhea by ketoprofen and indomethacin. 53 Dec 31

The efficacy of indomethacin suppositories (100 mg 1-3 times a day) in the treatment of primary dysmenorrhoea was investigated in a double-blind, crossover study involving 40 patients, in comparison to placebo. The patients were treated for four menstrual periods-two periods with placebo and two periods with indomethacin suppositories. A dysmenorrhoeic score based on subjective estimations of nine symptoms was used, the symptoms including pelvic pain, backache, headache, dizziness, nausea, vomiting, diarrhoea, nervousness and incapacitation. As compared to placebo, indomethacin suppositories led to a insignificant decrease in the frequency and severity of the associated symptoms, as evaluated by subjective rating (P less than 0.05). Indomethacin suppositories were well tolerated and there was no drop-out. No side effects were reported except for a mild burning sensation in the rectal region experienced by 3 patients on indomethacin suppositories.
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PMID:Efficacy of indomethacin suppository in primary dysmenorrhoea. 222 77

In most developed countries in which therapeutic abortions are legal, termination of pregnancy is performed at between 8 and 12 weeks of gestation. Because the complication rate after this procedure rises with increasing gestation, there would be many advantages in inducing abortion before the eighth week ('menstrual induction'). With the increasing availability of highly sensitive methods of detecting human chorionic gonadotropin, pregnancy can now be diagnosed as early as 10-14 days after conception. The uterus can be surgically evacuated safely and simply by suction aspiration under local anaesthesia. However, a safe and effective method of inducing abortion by medical means would be a useful and cheaper alternative. Of the potentially useful compounds, only derivatives of prostaglandins E and F administered by vaginal pessary have so far been shown to be effective. Although the rate of haemorrhage and infection is low, 10-30% of women experience moderate side-effects of pelvic pain, diarrhoea and/or vomiting. The possibilities are discussed of reducing the incidence of side-effects by different methods of release or using prostaglandins in combination with other compounds such as antigestogens which might lower the therapeutic threshold.
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PMID:Menstrual induction: surgery versus prostaglandins. 386 9

2 case histories of severe pelvic infection and tuboovarian abcesses associated with use of the Majzlin Spring intrauterine device are presented. A 30-year-old parous white woman and a 25-year-old parous black woman were admitted to the Brooklyn-Cumberland Hospitals on separate occassions with a history of prolonged fever, diarrhea, pelvic pain and vomiting. After failure of antibiotic therapy, exploratory laparotomies revealed severely infected ovarian cysts and tuboovarian abscesses with the Majzlin Spring device deeply implanted in the endometrium. Total abdominal hysterectomies and bilateral salpingo-oophorectomies were performed. Although preexisting disease conditions could have existed in these women before the IUD insertion, a cause-and-effect relationship between the IUD as a carrier of a superimposed infection and these conditions should be considered. Much greater care should be taken in the insertion, re-insertion, and follow-up of these devices.
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PMID:Tuboovarian abscess and the intrauterine device (Majzlin Spring). 469 75

A review was made of clinical and laboratory findings in 104 women who, during 1978 to 1981, were subjected to laparoscopy because of symptoms suggestive of acute salpingitis, and who harbored Chlamydia trachomatis but not Neisseria gonorrhoeae in the genital tract. The patients with acute salpingitis (N = 76) did not differ significantly from those with visually normal fallopian tubes (N = 28) in regard to age distribution, parity, contraceptive method used, proportion of women with urethritis symptoms, increased vaginal discharge, vomiting, diarrhea, elevated rectal temperature, elevated white blood cell count, and palpable pelvic masses. The acute salpingitis patients more often had irregular bleeding and an elevated erythrocyte sedimentation rate, whereas the patients without acute salpingitis more often had a short history of pelvic pain. The two groups overlapped considerably with respect to the number of symptoms and clinical signs of pelvic infection. The results emphasize the value of laparoscopy in the diagnosis or exclusion of a tubal infection in association with a chlamydial genital infection and pelvic pain, even if there are comparatively few additional symptoms of ascending infection.
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PMID:Laparoscopy in women with chlamydial infection and pelvic pain: a comparison of patients with and without salpingitis. 621 34

The physiology of primary dysmenorrhea and its treatment with nonsteroidal anti-inflammatory agents are reviewed. Primary dysmenorrhea involves incapacitating pelvic pain associated with nausea, vomiting, and diarrhea. Currently, it is thought to be caused by an overproduction of prostaglandins that are released as the endometrium degenerates. Since the nonsteroidal anti-inflammatory agents are one class of antiprostaglandin agents, they are frequently prescribed for the relief of dysmenorrhea. Naproxen and naproxen sodium have both been shown to be superior to placebo in subjective and objective assessments of dysmenorrheic patients when administered at the onset of symptoms. Indomethacin studies demonstrate its efficacy over placebo, but the frequency of side effects at the doses used (25-50 mg t.i.d.) diminish its usefulness. Few placebo-controlled studies have been published on ibuprofen, but the studies that have been performed show that ibuprofen is more beneficial than placebo for treating dysmenorrhea with a low incidence of side effects. The fenamates appear to be effective in dysmenorrhea, although they were not studied extensively with placebo and previous experience with mefenamic acid has led to warnings about side effects. Phenylbutazone and oxyphenbutazone have been found to be effective; however, their use has been less frequent since the introduction of the newer less toxic nonsteroidal agents. Comparative studies of the nonsteroidal anti-inflammatory agents have not indicated that one agent is more effective than the others. Until further well-controlled comparative research is performed, any of the agents reviewed would be an appropriate choice in the treatment of primary dysmenorrhea.
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PMID:Nonsteroidal anti-inflammatory agents in the treatment of primary dysmenorrhea. 676 92

In order to evaluate the contribution of tubal spasm to pelvic pain following laparoscopic sterilisation, we have studied the effect of glycopyrrolate, an anticholinergic agent with antispasmodic properties, on 60 ASA 1 and 2 patients presenting as day-cases for laparoscopic sterilisation using Filshie clips. In a randomised, double-blind, controlled trial, patients received either glycopyrrolate 0.3 mg or saline intravenously prior to induction of anaesthesia. Compared with the control group, patients receiving glycopyrrolate had significantly reduced immediate postoperative pain scores (p < 0.02) and required significantly less postoperative morphine (p < 0.01). Nausea, vomiting and anti-emetic requirements were also reduced though not significantly. We conclude that glycopyrrolate 0.3 mg at induction of anaesthesia is an effective method of improving the quality of recovery after day-case laparoscopic sterilisation using clips.
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PMID:The effect of glycopyrrolate on postoperative pain and analgesic requirements following laparoscopic sterilisation. 903 63

This open multicenter study was performed in 20 hospital gynecological units in the UK. The effects of 600 mg oral mifepristone as pretreatment to vaginal prostaglandin induction of second trimester abortion was studied in 267 women. The primary efficacy variable was the abortion induction interval, defined as the time taken to expel the fetus from the time of administration of the first prostaglandin pessary. Induction was commenced 36 to 48 hours following mifepristone intake. The mean abortion induction interval was 7 h. A total of 81.9% of women aborted within 12 h. There was a significant relationship between abortion induction interval and age of gestation, and a significant inverse relationship between abortion induction interval and parity. Vomiting, pelvic pain, and nausea were the most frequently reported adverse events. Two patients required transfusion and one patient with a uterine scar from a previous cesarean section suffered a ruptured uterus and hysterotomy.
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PMID:Oral mifepristone 600 mg and vaginal gemeprost for mid-trimester induction of abortion. An open multicenter study. UK Multicenter Study Group. 949 69

The safety and effectiveness of oral methotrexate and vaginal misoprostol for early abortion were evaluated in a prospective study of 300 women who presented to the Cuidad de la Habana (Havana, Cuba) for termination of a pregnancy of a gestational age of 63 days or less. All women were given 50 mg of methotrexate at study entry and then were randomly allocated to receive 800 mcg of misoprostol either 3, 4, or 5 days later. If abortion did not occur, misoprostol was readministered 48 and 96 hours later. Complete abortion occurred in 273 women (91%); the success rate was 72% (216 cases) after just one dose of misoprostol. There were no significant differences in abortion rates based on the day on which misoprostol was administered. Vaginal bleeding lasted an average of 7.1 +or- 3.8 days, spotting continued for 4.1 +or- 2.5 days, and total bleeding persisted for 11.2 +or- 4.1 days. Side effects for methotrexate included nausea (9.7%), vomiting (6.7%), dizziness (10.3%), fatigue (6.3%), headache (5.3%), and chills (5.3%). For misoprostol, side effects included nausea (23.0%), vomiting (25.3%), diarrhea (51.7%), dizziness (18.3%), headache (18.0%), chills (60.0%), and pelvic pain (97.3%). All signs and symptoms were of low intensity and short duration, however. These results suggest that combined use of methotrexate and misoprostol represents a feasible alternative to the intramuscular use of methotrexate or of antiprogestins and prostaglandin for medical abortion. The efficacy and safety of this new regimen are very close to those of RU-486, but the cost is considerably less.
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PMID:Oral methotrexate and vaginal misoprostol for early abortion. 958 33

The effectiveness and safety of vaginal misoprostol, without the need for postexpulsion systematic curettage, were investigated in 120 Cuban women seeking late first-trimester abortion (10-12 weeks). Women received 800 mcg of misoprostol vaginally every 24 hours, for a maximum of three doses. Complete abortion occurred in 104 women (87%); 87 women (73%) aborted after a single dose, 11 (9%) required two doses, and 6 (5%) received a third dose. The remaining 16 women (13%) underwent surgical abortion. Mean hemoglobin decreased from 12.2 mg/dl before treatment to 11.6 mg/dl after abortion--a difference that was statistically but not clinically significant. Side effects--which disappeared within 2 hours--included nausea (22%), vomiting (17%), diarrhea (54%), dizziness (25%), headache (19%), and chills (72%). Although 99% of subjects reported pelvic pain (99%), only 10% requested an analgesic for pain relief. Vaginal bleeding persisted for a mean of 8 days. According to logistic regression analysis, the only variable significantly associated with treatment success was race. The success rate was 94% among White women compared with 73% among Black and Black Cuban women. The acceptable expulsion period, the fact that a postabortion systematic curettage was not required, the clinically insignificant hemoglobin loss, and the high success rate all demonstrate that misoprostol administered vaginally may be a valid method for interrupting late first-trimester pregnancies.
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PMID:Vaginal misoprostol for late first trimester abortion. 967 40


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