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

Endometriosis, the growth of ectopic endometrial tissue, is a chronic recurrent disease affecting 10% of the female population causing dyspareunia, pelvic pain, dysmenorrhea, and infertility. Suppression of ovarian activity is the cornerstone of medical therapy with limited benefit and severe adverse effects. Angiogenesis plays a major role in the development of endometriosis suggesting that anti-angiogenic therapy would offer a new therapeutic approach. We report successful treatment of endometriosis in estrogen-supplemented ovariectomized mice by transient overexpression (6 to 10 days of duration) of the gene for a natural angiogenesis inhibitor angiostatin, delivered to the peritoneum by a replication-deficient adenovirus vector (AdAngiostatin). Established endometriosis was eradicated in 14 of 14 AdAngiostatin-treated animals, whereas 11 of 13 control animals showed full disease development. Administered to normal cycling mice for the same transient period, AdAngiostatin caused impaired ovarian function with suppressed corpus luteum development, decreased production of estradiol and progesterone, decreased ovarian and uterine weight, and increased body weight. AdAngiostatin treatment lowered the levels of sex steroids but did not induce total castration. Gene therapy with angiogenic inhibitors is a highly effective treatment for endometriosis, even in a host with preserved estrogen levels. However, local or targeted delivery of the gene must be considered to avoid prolonged systemic effects and impaired ovarian function.
Am J Pathol 2002 Sep
PMID:Therapeutic effect of angiostatin gene transfer in a murine model of endometriosis. 1221 19

An evaluation is made of laparoscopy in the case of pelvic pains. Laparoscopy is an excellent method for diagnosis, but should not be performed systematically; it is expensive and in some cases, may endanger the patient. The clinical examination must be done extremely carefully. Laparoscopy should be considered only if the clinical examination does not explain at all the cause of the pain. Most doctors believe that laparoscopy should be performed if the clinical examination is negative or uncertain, if the pain is serious or old, and if the treatments administered have not worked. Laparoscopy allows for recognition of lesions, avoids inadequate treatments and performs therapeutic tests. Laparoscopy does not solve all problems of pelvic pain, and it is often difficult to determine whether the lesion discovered is actually responsible for the pain. It is concluded that although it is a precious tool for diagnosis, laparoscopy is sometimes insufficient, and often unnecessary; the symptoms of the patients should first be analysed very carefully and one should not perform laparoscopy systematically.
Contracept Fertil Sex (Paris) 1977 Sep
PMID:[Laparoscopy in pelvic pains]. 1226 Jul 87

Based on research studies and analysis of Family Health International's IUD data set, breastfeeding women should be considered good candidates for IUD use. Neither the quantity nor quality of breastmilk has been found to decrease discernibly among lactating IUD users. Additionally, breastfeeding women experienced easier and less painful IUD insertion than non-breastfeeding women, while women amenorrheic at insertion were less likely to have removals due to bleeding or pain complications. Finally, no apparent increased risk of uterine perforation or intermenstrual pelvic pain was found from insertion of the TCu 380A IUD among breastfeeding women.
Netw Res Triangle Park N C 1991 Sep
PMID:Breastfeeding women are good IUD candidates. 1228 79

The use of silicone rings and metal or plastic clips in laparoscopic sterilization is discussed. Sterilization by these techniques eliminate s the risk of accidental burns associated with electrocautery methods. Nonetheless, accidental tubal transection and abdominal pain are potential complications of the ring technique. The incidence of the latter, however, can be markedly reduced by the application of xylocaine jelly to the ring prior to the operation. Experience with the clip technique has shown the procedure to involve more operative difficulties than coagulation techniques. Pelvic pain with the clip technique is reportedly more common than with the electrocautery procedure, while chest or shoulder pain is more frequent with the latter technique. Complication rates for the cautery, clip, and ring methods are similar, though technical difficulties and failures are more common with spring-loaded clips. Trials have shown the laparoscopic approach to sterilization to be safer than other interval sterilization techniques.
Int Fam Plann Dig 1975 Sep
PMID:Silicone rings, metal, plastic clips may eliminate cautery hazards in laparoscopic sterilization. 1230 95

A CT guided lateral approach for neurolysis of the presacral plexus is described for treatment of pelvic pain due to advanced cancer. The technique was evaluated in two patients with unrelieved pelvic and perineal pain. Other neurolytic techniques used to treat pelvic pain due to advanced cancer are reviewed with a discussion of benefits and potential side effects of this technique.
Palliat Med 2002 Sep
PMID:Presacral neurolytic block for relief of pain from pelvic cancer: description and use of a CT-guided lateral approach. 1238 Jun 63

The authors report a rare clinical case of coincidence appendicitis and Fallopian tube torsion. A 14-years-old girl is presented with acute pelvic pain, dysuria and diarrhoea. Acute appendicitis and right side Fallopian tube torsion were detected by laparotomy. Symptoms, differential diagnoses, etiology and diagnostic procedures are discussed.
Rozhl Chir 2002 Sep
PMID:[Fallopian tube torsion in appendicitis--case report]. 1251 7

The first empirical use of alpha(1)-adrenoceptor antagonists in urology occurred about 25 years ago in patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH), or LUTS/BPH. Today, many randomized, controlled trials have provided evidence for the efficacy and tolerability of alpha(1)-adrenoceptor antagonists in LUTS/BPH, and they are the most frequently used initial treatment option for this cause of LUTS. For many years, alpha(1)-adrenoceptor antagonists have also been used empirically in other types of lower urinary tract dysfunction (LUTD), such as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and neurogenic LUTD (NLUTD). Several investigators have shown that alpha(1)-adrenoceptor antagonists may be useful in patients with CP/CPPS. This was recently confirmed by a 6-week, double-blind, placebo-controlled pilot study evaluating the efficacy and safety of tamsulosin in 58 CP/CPPS patients. Further well-designed and -powered research into the use of alpha(1)-adrenoceptor antagonists in patients with CP/CPPS is currently ongoing. Several small-scale predominantly open-label studies have suggested that alpha(1)-adrenoceptor antagonists may be of benefit in patients with NLUTD. Data from 2 recent large-scale studies with tamsulosin in patients with NLUTD caused by suprasacral spinal cord injury suggest that long-term tamsulosin treatment improves bladder storage and emptying and also reduces symptoms of autonomic dysreflexia. Tamsulosin has also shown promise in ameliorating (early) storage symptoms and urinary retention associated with transurethral microwave thermotherapy, external-beam radiotherapy, and brachytherapy. In BPH patients presenting with the ultimate form of LUTS-acute urinary retention-treatment with tamsulosin before catheter removal results in a higher success rate of catheter-free voiding. Finally, it seems that alpha(1)-adrenoceptor antagonists may reduce the occurrence of urinary retention after (general) surgery. We can therefore conclude that alpha(1)-adrenoceptor antagonists, such as tamsulosin, may be useful for treating men with LUTS beyond BPH.
Urology 2003 Sep
PMID:The use of alpha1-adrenoceptor antagonists in lower urinary tract symptoms: beyond benign prostatic hyperplasia. 1295 98

Chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) is a common problem of medically controversial condition that causes considerable morbidity and impact on life. Although there are many competing causes proposed, the etiology and pathogenesis of CP/CPPS remain unclear. The causative factors underlying the CPPS are not fully understood. The optimal management of CP/CPPS is still unknown. The guideline of diagnosis and management of CP/CPPS based on evidence base medicine is not yet established. Many problems are still not resolved, such as the significance of leukocytes and the role of inflammation in CP/CPPS, the significance of bacteria presence and the role of infection in CP/CPPS, the correlation between leukocytes/bacteria and severity of symptoms, how to divide the subgroups of CP/CPPS, the role of antimicrobial therapy in the treatment of men with CP/CPPS, why patients with category IIIb complain of symptoms, while those with category IV complain of none. Although CP/CPPS is now achieving greater recognition, well-designed studies with large sample size should be performed.
Zhonghua Nan Ke Xue 2003 Sep
PMID:[Some controversial conditions in the management of chronic prostatitis/chronic pelvic pain syndrome]. 1457

Endometriosis is a pain syndrome representing a major cause of pelvic pain in women of reproductive age. The aim of this study was to test the hypothesis that persistent nociceptive input from endometriotic tissues leads to central sensitization manifested by somatic hyperalgesia and increased referred pain areas to experimental saline-induced muscle pain in patients with endometriosis, compared to healthy control subjects. Ten women with laparoscopically confirmed endometriosis and 10 healthy, age-matched women participated in the study. Hypertonic saline (0.5 mL, 5.8%) was injected intramuscularly, in random succession, into 1 site of menstrual pain referral (the multifidus muscle at the low back) and into 1 non-pain control site (first dorsal interosseous muscle [FDI] of the hand). The post-saline pain intensity and pain areas at the FDI were significantly greater in patients with endometriosis than in control subjects (P <.05) but were not different between the groups for the back. An absence of enhancement of post-saline pain responses at the back in the endometriosis group suggests that saline-induced pain at the back appears to activate segmental inhibitory systems in patients with endometriosis. Manifestation of central sensitization in women with endometriosis is demonstrated by increased muscle nociceptor input in the form of increased post-saline pain intensity, pain areas at the FDI, and hypersensitivity to pressure stimulation. These findings provide new insights into the complex pain mechanisms associated with endometriosis.
J Pain 2003 Sep
PMID:Endometriosis is associated with central sensitization: a psychophysical controlled study. 1462 79

Adverse and analgesic effects of acupuncture during the second and third trimesters of pregnancy were studied retrospectively in an observational study including 167 consecutive patients with lower back pain, pelvic pain, or both. In each patient acupuncture was given on at least two different occasions by three manual stimulations of two or more acupuncture or tender points, mainly LR-3 and LI-4 together with local tender points, at 15-min intervals. Possible adverse and analgesic effects were assessed by the midwife responsible for the acupuncture given in each patient. There were no abortions and no influence on the delivery course of the infants, but transient premature labor was observed during the fourth stimulation carried out in the 15th gestational week in one woman. Other possible adverse effects, like transient dizziness or tiredness, were reported in 35 patients (21%). Analgesia, as assessed by midwives involved, was good or excellent in 72% of patients. Acupuncture seems to be safe and effective for pain relief in lower back pain, pelvic pain, or both during the second and third trimesters of pregnancy. Nevertheless, prospective randomized studies are needed to confirm these findings.
Pain Med 2001 Sep
PMID:Acupuncture for lower back and pelvic pain in late pregnancy: a retrospective report on 167 consecutive cases. 1510 52


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