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

Uterine fibroids, the most common tumours in women of reproductive age, are asymptomatic in at least 50% of afflicted women. However, in other women, they cause significant morbidity and affect quality of life. Clinically, they present with a variety of symptoms: menstrual disturbances including menorrhagia, dysmenorrhoea and intermenstrual bleeding; pelvic pain unrelated to menstruation; and pressure symptoms such as a sensation of bloatedness, increased urinary frequency and bowel disturbance. In addition, they may compromise reproductive function, possibly contributing to subfertility, early pregnancy loss and later pregnancy complications such as pain, preterm labour, malpresentations, increased need for caesarean section, and postpartum haemorrhage. Large fibroids may distend the abdomen, which may be aesthetically displeasing to many women. Abnormal bleeding occurs in 30% of symptomatic women, and abnormal bleeding, bloating and pelvic discomfort due to mass effect constitute the most common symptoms. The incidence of fibroids is highest in Black women, who tend to have multiple and larger fibroids, and more symptomatic fibroids at the time of diagnosis. The prevalence of clinically significant myomas peaks in the perimenopausal years and declines after the menopause. It is not known why some fibroids are symptomatic while others are quiescent. The size, number and location of fibroids undoubtedly determine their clinical behaviour, but research has yet to correlate these parameters with clinical presentation of the fibroids.
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PMID:Clinical presentation of fibroids. 1837 19

Growing clinical and scientific data imply that the condition currently called interstitial cystitis is not just a mere bladder end-organ disease but that the symptoms perceived to be related to the bladder are rather one aspect of a complex pelvic pain syndrome. The term bladder pain syndrome/interstitial cystitis (BPS/IC) suggested by the European Society for the Study of IC/PBS (ESSIC) for this condition is currently the only one strictly consistent with the taxonomy guidelines of the European Association of Urology and the International Association for the Study of Pain. BPS would be diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom such as persistent urge to void or urinary frequency. Confusable diseases as the cause of the symptoms must be excluded. Classification of BPS types might be performed according to findings at cystoscopy with hydrodistention and morphologic findings in bladder biopsies. The end-organ condition interstitial cystitis has thus become a chronic pain syndrome with a predominantly neurovisceral pathophysiology. In daily practice, therapeutic approaches aiming at both the peripheral bladder urothelium and central nervous targets should be combined. A multimodal treatment strategy, such as the combination of tricyclic antidepressants with instillation therapy, still appears reasonable and justified.
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PMID:[From end-organ disease to a classifiable bladder pain syndrome: paradigm shift in the understanding of urological pain syndromes exemplified by the condition currently called interstitial cystitis]. 1894 52

Serous psammocarcinoma (SPC) is a rare variant of ovarian carcinoma or peritoneum that may present with features consistent with malignancy, or tumors of low malignant potential. This is two-case reports of a SPC of the ovary and peritoneum and review of the literature. A 41-year-old woman was referred to our clinic for adnexal mass. Ultrasonography revealed endometrioma. Endometriotic cyst excision and sacrouterine biopsy were performed via laparoscopy. Histological examination revealed endometrioma and psammocarcinoma of the peritoneum. Staging laparotomy was performed. She received six courses of chemotherapy. She has no evidence of disease after 6 years from surgical therapy and chemotherapy. A 50-year-old woman presented with pelvic pain and discomfort in the upper abdomen with nausea and emesis. CT scan showed extensive tumor in the lower abdomen, and free fluid in the abdomen and pelvis which appeared to be an ovarian tumor. She underwent a laparotomy and a right and left ovarian tumor measuring about 20 x 15 and 8 x 8 cm, respectively, were seen. Staging procedure was performed. Microscopic examination revealed SPC of the ovary. Chemotherapy was planned. The biologic behavior of this disease remains unresolved. Primary surgical debulking should be attempted, while the utility of postoperative chemotherapy remains unknown.
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PMID:Serous psammocarcinoma of the ovary and peritoneum: two case reports and review of the literature. 1898 36

Uterine artery embolization (UAE) is an effective treatment for symptomatic uterine fibroids. Magnetic resonance (MR) imaging is typically employed to evaluate the uterus following UAE for fibroid infarction, size, location change, persistent enhancement, changes in adenomyosis, and uterine necrosis. Variable pattern of calcification on computed tomography (CT) can differentiate embolic particles and fibroid involution. CT following UAE may be requested because of acute pelvic pain or chest discomfort or pyrexia and/or for complications that may require treatment in acute phase. Visualization of gas in uterus and uterine vessels following UAE is an expected finding that should not be misinterpreted as a sign of infection. The MRI and CT appearances vary depending upon the time interval after UAE and success of the procedure. Radiologists should be familiar with the range of post-UAE appearances on MRI and CT to better aid clinicians in correct diagnosis and treatment. The main purpose of this pictorial review is to identify the spectrum of findings on MRI and CT performed after UAE, to illustrate UAE-associated common and uncommon MRI and CT appearances and discuss post-UAE complications that require urgent medical or surgical intervention.
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PMID:Spectrum of imaging findings on MRI and CT after uterine artery embolization. 1904 34

Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic syndrome characterized by irritative voiding symptoms and pelvic pain or discomfort. IC/PBS represents localized bladder pathophysiologic changes and central nervous system upregulation. Patients exhibit bladder hyperalgesia and allodynia. Childhood sexual abuse occurs in up to 27% of females in the United States. Adults with a prior history of abuse or traumatization demonstrate hypothalamic-pituitary-adrenal (HPA) axis abnormalities, similar to IC/PBS patients. Childhood sexual abuse and physical traumatization are associated with subsequent lifelong risks of chronic pain syndromes. IC/PBS patients have increased rates of sexual abuse or physical traumatization histories compared with controls. IC/PBS patients with abuse histories tend to have greater pain intensity and lesser irritative voiding symptoms compared with nonabused IC/PBS patients. This article reviews the relationship between sexual abuse, HPA axis abnormalities, IC/PBS pathophysiology, and the role of sexual abuse on subsequent IC/PBS.
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PMID:The relationship between sexual abuse and interstitial cystitis/painful bladder syndrome. 1986 55

Bladder pain syndrome is a deceptively intricate symptom complex that is diagnosed on the basis of chronic pelvic pain, pressure, or discomfort perceived to be related to the urinary bladder, accompanied by at least one other urinary symptom. It is a diagnosis of exclusion in a patient who has experienced the symptoms for at least 6 weeks in the absence of any confusable diseases that may give rise to the symptoms. Symptoms compatible with the diagnosis are now thought to affect up to 3% of the female population in the United States with a 5:1 female-to-male preponderance. Diagnosis and treatment can be challenging, and misdiagnosis as a psychological problem, overactive bladder, or chronic urinary infection has plagued patients with the problem.
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PMID:Bladder pain syndrome. 2109 11

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common male pain condition that is associated with significant discomfort and disability. Despite significant efforts, there remains no definitive etiology or treatment of the spectrum of pelvic symptoms reported by these patients. The purpose of this review is to summarize important clinical and scientific findings related to CP/CPPS from the previous 2 years, and to evaluate their impact on our understanding of, and approach to, the disease.
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PMID:New paradigms in understanding chronic pelvic pain syndrome. 2144 31

Malignant ascites affects approximately 10% of patients with recurrent epithelial ovarian cancer and is associated with troublesome symptoms, including abdominal pressure and distension, dyspnea, bloating, pelvic pain, and bowel/bladder dysfunction. To date, no effective therapy has been identified for the treatment of malignant ascites in patients with recurrent, advanced ovarian cancer. In this article, we discuss currently existing options for the treatment of ascites associated with ovarian cancer, and review the literature as it pertains to novel, targeted therapies. Specifically, preclinical and clinical trials exploring the use of the antiangiogenic agents, bevacizumab and vascular endothelial growth factor-trap, as well as the nonangiogenic agent, catumaxomab, will be reviewed. Despite current limitations in treatment, knowledge regarding management options in the palliation of ascites is critical to practicing physicians. Ultimately, as with all novel therapies, symptom relief and treatment goals must be weighed against patient discomfort and potentially significant adverse events.
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PMID:Emerging treatment options for management of malignant ascites in patients with ovarian cancer. 2292 70

Acute prostatitis is infrequent and is manifested as a severe systemic infection requiring hospitalization. Some of these cases may result in a chronic infection requiring long-term antibiotic courses. However, chronic non-bacterial prostatitis is much more frequent, and as such, it it is frequently underdiagnosed and maltreated. The symptoms are variant and include pain and discomfort in the pelvic area, perineum, scrotum, penis and pelvis, and are named "Chronic pelvic pain syndrome (CPPS)". Antibiotics prescribed are of temporary relief in some of the cases as the disease does not really fit the criteria of an infectious disease. This review deals with these difficulties and describes new and other methods to fight this frustrating syndrome for both patients and urologists.
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PMID:[Chronic prostatitis and chronic pelvic pain syndrome]. 2336 50

Chronic prostatitis is a disease caused by a number of factors characterized by perineal discomfort, pelvic pain, irritative urination symptoms and even sexual dysfunction, and histologically with infiltration of poly-and mononuclear cells in the interstitial connective tissue. Research on this disease has somewhat been hindered, for its pathogenesis and diagnostic criteria are not yet clear. Animal models can help to explain the pathogenesis of chronic prostatitis and chronic pelvic pain syndrome. This article presents an overview on the advantages and limitations of rodent models in the studies of this disease.
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PMID:[Animal models of chronic prostatitis: an update]. 2443 28


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