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)

A 14-year-old girl presented with classic McCune-Albright syndrome. She underwent the ablation of several cysts during a laparotomy performed on the basis of persistent and intense pelvic pain and recurrent episodes of menometrorrhagia not responsive to pharmacologic therapy. Granulosa cells obtained from an isolated follicle and a cyst were cultured and estradiol (E2) secreted in the culture medium measured. Granulosa cells, obtained from the follicle, produced much higher levels of estradiol compared to those of cells coming both from follicles of equivalent size and preovulatory follicles of normal patients. Secretion of E2 by granulosa cells from the cyst was comparable to that of normal preovulatory follicles. We conclude that in this patient, ovaries are hyperfunctioning in terms of E2 production. This high production of estradiol and the fact that several cysts were found in the ovaries can justify the high levels of estradiol found in the serum of this patient at the moment of the operation.
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PMID:In vitro production of estradiol by ovarian granulosa cells in a case of McCune-Albright syndrome. 186 81

Menometrorrhagia and hypermenorrhoea are often present in patients who also suffer from a state of insufficiency of the utero-adnexal venous system interpretable as a clinical entity of system pathology and accompanied by pictures of acquired venous ectasis. The lack of any easy clinical characteristic objectivisation often prevents easy recognition and complex diagnostic investigation is therefore indispensable. Treatment is often destructive surgery following the failure of the various medical or conservative surgical therapies that are tried. Personal experience in cases in which the clinical picture (big uterus, menometrorrhagia, pelvic pain) presents a pathology of the venous vascular system, can report considerable benefit first and disappearance later of the symptomatology, with treatment using danazol at a dose of 200-300-400 mg/die. This makes demolition surgery, which is not often well accepted by the patient, inopportune.
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PMID:[Clinical aspects of pelvic histangiopathies. New therapeutic possibilities with danazol]. 194 28

The clinical and pathological features of 25 serous papillary cystadenomas of borderline malignancy of the broad ligament were analyzed. The ages of the patients ranged from 19 to 67 (average, 32) years. The clinical presentation was lower abdominal pain, pelvic pain or both in five cases, accompanied by menometrorrhagia or amenorrhea in three cases. One patient was thought to have an acute abdominal disorder. The tumors of the remaining 19 patients were discovered either on routine gynecological examination or during an evaluation of the pregnancy status of the patient. In 14 cases the tumor was located in the left broad ligament and in 11 cases it was on the right side; all the tumors were entirely separated from the ipsilateral ovary. On gross examination the tumors were 1-13 cm in greatest dimension, had smooth outer surfaces, and contained straw-colored, watery fluid. The inner lining bore single or multiple 0.3-2.5 cm excrescences. Microscopic examination revealed that the cyst walls and their excrescences were lined by simple to pseudostratified, cuboidal to columnar, focally ciliated epithelium. Slight nuclear atypism, very rare mitotic activity, and focal psammoma body formation were also found. The stroma resembled ovarian stroma but no primary follicles or follicular derivatives were identified. Twenty-three of the patients were alive and well from 0.5 to 11 years after excision of the tumor, one patient was disease-free for 8.5 years but died of an open-heart surgical procedure; and two patients were lost to follow-up examination.
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PMID:Serous papillary cystadenoma of borderline malignancy of broad ligament. A report of 25 cases. 339 8

Microbiological and histopathological specimens were obtained from three levels (fundal, middle and cervical) of the endometrium immediately after removing the uterus. Hysterectomy indication was menometrorrhagia and uterine fibroids in eight cases and chronic pelvic pain in two cases. All cultures for C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum, herpes simplex virus, anaerobic and facultative bacteria were negative. Histopathological examination showed few plasma cells in the endometrium in four cases with the presence of uterine fibroids and in one case with adenomyosis. These results suggest that the endometrial cavity of a nonpregnant uterus is sterile.
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PMID:Endometrial microbial flora of hysterectomy specimens. 366 72

A series of 90 endometrial biopsies and curettings originally diagnosed as chronic endometritis were reviewed and histological findings of plasma cells, lymphoid infiltrate, stromal necrosis, acute inflammation, lymphoid follicles, and epithelial atypia were correlated with the demonstration of chlamydial antigens by the immunoperoxidase technique. Chlamydial antigens were localized within endometrial epithelial cells in four cases. Although these four cases represented only 4% of the total number, chlamydial immunoperoxidase positivity was best discriminated by the severity of the inflammation and the presence of an acute inflammatory infiltrate. Among cases of severe endometritis 22% were chlamydia-positive, and in those cases with an associated acute inflammatory infiltrate, 57% were positive. A high index of suspicion of chlamydial infection should exist when severe endometritis is diagnosed in patients with clinical histories of post-abortal state, pelvic inflammatory disease, secondary infertility or menometrorrhagia, and chronic pelvic pain.
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PMID:Chlamydial endometritis. A histological and immunohistochemical analysis. 638 66

To evaluate the efficacy and safety of nafarelin before hysterectomy in a prospective placebo-controlled trial, we randomized 188 pre-menopausal women with uterine fibroids (n = 111), menometrorrhagia (n = 58) or pelvic pain (n = 19) to receive either nafarelin (200 micrograms twice daily as a nasal spray) or a placebo for 3 months before abdominal hysterectomy. The data analysis could be performed in 166 women, of whom 107 received nafarelin and 59 a placebo. Nafarelin led to a rise in blood haemoglobin (5.5 g/l) and to a decrease in uterine volume (23.7%). This, however, gave no objective benefit during surgery (similar operative durations and blood losses). The uteri from patients treated with nafarelin (255.5 +/- 12.6 g, mean +/- SD) were significantly lighter (P = 0.029) than those from patients treated with a placebo (346.2 +/- 35.7 g). Histological examination of the fibroids or uteri revealed changes typical for hypo-oestrogenism, but no specific histological pattern could be established. The endometrium was proliferative in 56% and showed mild hyperplastic features in 10% of patients given nafarelin, whereas the respective figures for the placebo group were 41 and 0%. Hot flushes were the most common side-effects, being reported by 61% in the nafarelin group and 35% in the placebo group. Nafarelin can be useful as a pre-surgical adjunct in a patient scheduled for abdominal hysterectomy if there is a need to raise the haemoglobin concentration or to reduce the size of the uterus.
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PMID:Decrease in symptoms, blood loss and uterine size with nafarelin acetate before abdominal hysterectomy: a placebo-controlled, double-blind study. 759 17

A patient with synchronous multiple malignant neoplasms of the female genital tract, involving the ovary, the cervix and the endometrium is described. A 49-year-old patient, presenting pelvic pain and menometrorrhagia over the last six months. An abdominal and speculum examination revealed an abnormal mass occupying the entire left lower quadrant and a vegetating tumor of the cervix, respectively. Microscopic examination of the uterus and ovary revealed a cystadenocarcinoma of the ovary and an adenosquamous carcinoma of the cervix and an endometrioid carcinoma of the endometrium. The data suggests this is a multiple mullerian tumor. Due to treatment and prognostic implications, in the presence of a patient with a tumor involving different organs, we must not overlook differential diagnosis between primary and metastatic tumor.
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PMID:[Primary malignant neoplasms of the female genitalia]. 853 21

Between April 1993 and November 1995 I performed 50 laparoscopic hysterectomies. The indications for surgery were chronic menometrorrhagia in 40 women, enlargement of the uterus in 8, and pelvic pain in 2. Bipolar coagulation was used in the first 20 cases exclusively and a combination of Endo GIA 30 and bipolar in the other 30. The operating time using only bipolar coagulation ranged from 90 to 120 minutes and with the Endo GIA 30 from 60 to 150 minutes. The mean hospital stay was 36 hours. Only four procedures were converted to laparotomy, three for uncontrolled bleeding and one for bladder injury. The two complications were a vesicovaginal fistula and a vaginal infection. I believe that laparoscopic hysterectomy can be performed when the surgeon has appropriate training in vaginal and general surgery.
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PMID:Laparoscopic Hysterectomy 907 37

Leiomyomata represent the most common gynecologic tumors and are responsible for over 200,000 hysterectomies per year. They are almost invariably benign and represent clonal expansion of individual myometrial cells. They can cause a variety of symptoms including menometrorrhagia, dysmenorrhea, pelvic pain, reproductive failure, and compression of adjacent pelvic viscera, or be totally asymptomatic. Leiomyomata are more common in African-American women and have a non-Mendelian inheritance pattern with up to a 50% recurrence rate after surgical removal. The therapeutic choices depend on the goals of therapy, with hysterectomy most often used for definitive treatment, and myomectomy when preservation of childbearing is desired. Intracavitary and submucous leiomyomata can be removed by hysteroscopic resection. Laparoscopic myomectomy is now technically possible but apparently with an increased risk of uterine rupture during pregnancy. Although gonadotropin-releasing hormone-agonist-induced hypogonadism can reduce the volume of leiomyomata, the severe side effects and prompt recurrences make them useful only for short-term goals such as reversing anemia or shrinking an intracavitary tumor prior to hysteroscopic resection. Nonextirpative approaches such as myolysis and uterine artery embolization are being evaluated, and may provide more options if they prove to be safe and efficacious in long-term follow-up. Ultimately, if the genetic basis for fibroid development and/or the molecular mechanism(s) of myometrial proliferation are understood, additional nonsurgical therapeutic interventions may be forthcoming. Current clinical needs are to a) determine an effective prevention strategy in genetically predisposed individuals; b) slow the growth of leiomyomata; c) identify the mechanisms of infertility; d) improve early detection; e) develop better surgical techniques; f) reduce recurrences after myomectomy; g) develop nonextirpative options; and h) evaluate their long-term results.
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PMID:Clinical decision making regarding leiomyomata: what we need in the next millenium. 1103 91

This essay on the effects of modern effective contraception on psychological and sexual behavior concentrates on the characteristis of French society. Contraception is obviously a weapon against multiple illegal abortons, and a means for professional, social and sexual liberation of women. For physicians it provides a medium of interacting for the first time with the sexual life of patients, sometimes resulting in spectacular cures of psychosomatic disorders such as pelvic pain, menometrorrhagia, depression and anxiety. The opportunity for more frequent sexual relations, free of fear of pregnancy, may permit the release of orgasm and an experience of new sensation, authenticity and confidence for the woman. But contraception may also reveal or aggravate sexual dysfunction and participate in the deterioration of sexual adjustment. The physician must be aware of patients' prior psychosexual situation in order not to make contraception a scapegoat for so-called pill or IUD side effects. This requires sound medical training and a good doctor-patient relationship. For many young women maternity is the sign of womanhood, and for mature women and their partners, fertility is the essence of feminine attraction. This unconscious belief is often the basis for forgetting pills, frigidity, impotence and masochistic pregnancy. Children are unconsciously the bridge toward immortality.
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PMID:[Influence of contraception on psychology and sexual life]. 1230 76


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