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)

Forty-seven patients underwent laser laparoscopic management of endometriomas from 3 to 12 cm in diameter. Eighteen patients had infertility, 15 had pelvic pain, and 14 had both. The types of laser used were the carbon dioxide, argon, and potassium-titanyl-phosphate. There were no surgical complications. Twelve of 32 patients with infertility achieved pregnancy after the initial procedure. Subsequently, 2 patients conceived after a second-look procedure. Twenty-three of 30 patients with pelvic pain reported improvement or resolution. We confirm the efficacy of operative laparoscopy using lasers in the management of large ovarian endometriomas.
 ...
PMID:Laser laparoscopic management of large endometriomas. 170 14

Heterotopic pregnancy (HT) in the absence of a previous ovarian hyperstimulation is a very rare condition. Transvaginal ultrasonography (TV) in the case of first trimester pelvic pain allows a high diagnostic reliability in the identification of HT and a successful conservative treatment by means of TV potassium chloride injection.
 ...
PMID:Heterotopic pregnancy in a woman without previous ovarian hyperstimulation: ultrasound diagnosis and management. 873 47

Interstitial cystitis (IC) remains a diagnosis of exclusion, based on the symptoms of urinary urgency, frequency, and pelvic pain in the absence of other definable causes. Certain areas of controversy in the field of IC research have a significant adverse affect on patients. Many physicians still do not believe that IC exists, or else believe that it is a rare postmenopausal condition. This can cause significant delays in diagnosis and treatment. It is particularly problematic in children, whose symptoms are often diagnosed as "voiding dysfunction" and are thought to be self-limiting. It can also be problematic for men, who are often unsuccessfully treated for prostatitis over the course of many years, and for whom the diagnosis of IC is never entertained. In some cases, when no diagnosis is made, patients are left to live with severe, debilitating symptoms and have nowhere to turn for help. Resistance to treating severe nonmalignant pain with opioid medication further compounds this problem and has led to suicide in this patient population. The "gold standard" of cystoscopy with hydrodistention is now being questioned, and an overreliance on the potassium test, which has a high false-negative rate, may lead to significant underdiagnosis of IC. New urinary markers hold promise for both diagnostic as well as therapeutic potential, but are not yet commercially available. IC may be an organ-specific disease in some patients and a systemic condition in others. Many patients have multiple disorders and have no physician to manage their overall health. The Interstitial Cystitis Association believes that the best way to address these unresolved areas of knowledge is to: (1) educate patients on all available diagnostic and therapeutic options so that patients, with the help of their physicians, can make the best informed decisions possible, and (2) aggressively pursue all avenues of research, particularly epidemiology.
 ...
PMID:Current controversies that adversely affect interstitial cystitis patients. 1137 55

Interstitial cystitis (IC) is a chronic condition characterized by a constellation of symptoms such as urinary frequency, nocturia, urinary urgency, suprapubic pressure, and bladder and pelvic pain. Since its original description, the etiology of the disorder has remained unknown despite intense investigations. The International Cystitis Association (ICA) and the National Institutes of Arthritis, Diabetes, Digestive and Kidney Diseases (NIDDK) have been instrumental in supporting the United States Interstitial Database (ICDB) and foster research to study the disorder. The NIDDK developed criteria to ensure that all groups of patients treated would be relatively comparable. However, many patients who would be clinically considered to have IC do not fulfill all the NIDDK criteria. Many clinical criteria for the diagnosis of IC, such as the presence of glomerulations and the intravesical potassium chloride test, are being challenged. The epidemiology of the disorder is not well established, but there are an estimated 700,000 cases of IC in the United States. Numerous pathophysiologic mechanisms have been proposed, but none have been proven. There is no representative animal model of IC. Both the oral and intravesical treatments of IC are noncurative, and few are based on a plausible mechanism or scientific evidence. Surgical treatment should be considered with extreme caution; it is the last therapeutic option because failure rate can be substantial.
 ...
PMID:Current investigations and treatment of interstitial cystitis. 1208 13

Recent data show that in the significant majority of gynecologic patients, chronic pelvic pain (CPP) has its origin in the bladder in the chronic disease process known as interstitial cystitis (IC). IC can produce pain that is perceived in any location or locations in the pelvis in any combination, with or without urinary frequency/urgency. Until recently, the diagnosis of IC was complicated by the variable clinical presentation of the disease and a lack of diagnostic tools. With recent advances in the understanding of the disease, IC's distinctive symptom complex has become well known, and new diagnostic tools are available. Gynecologists can now test CPP patients for the presence of IC using a simple questionnaire, the Pelvic Pain and Urgency/Frequency (PUF) Patient Symptom Scale, and a minimally invasive, office-based procedure, the potassium sensitivity test (PST). Along with a careful history attuned to the characteristic clinical presentation of IC, the PUF Scale and PST can help the gynecologist establish the diagnosis and offer appropriate treatment promptly. IC can be treated very successfully in the majority of cases.
 ...
PMID:Diagnosing chronic pelvic pain of bladder origin. 1508 62

Interstitial cystitis (IC) is a bladder syndrome of unknown etiology. The cause of IC is most likely multifactorial and includes genetic and environmental factors. Various pathophysiological changes in the bladder, pelvis, and peripheral and central nervous systems have been identified, and this has led to the emergence of biologically specific treatment modalities. Interstitial cystitis is being diagnosed with increasing frequency; however, current diagnostic criteria are non-uniform, and there is significant overlap between chronic pelvic pain syndromes in men and women, interstitial cystitis, recurrent "cystitis," and the overactive bladder syndrome. The diagnosis of interstitial cystitis can be made clinically and by cystoscopy and hydrodistension. The sensitivity and specificity of urinary markers and the potassium sensitivity test have not been prospectively studied.
 ...
PMID:Etiology, pathogenesis, and diagnosis of interstitial cystitis. 1698 36

In this article, we report a study that assessed the prevalence of interstitial cystitis (IC) in a primary care office using symptom-based and improved diagnosis-based assessment modalities. Over the course of 1 year, all patients > or = 18 years of age who presented for a primary care office visit were administered the Pelvic Pain and Urgency/Frequency (PUF) questionnaire. Patients with potential IC as indicated by PUF score were selected for further interview and, when appropriate, a Potassium Sensitivity Test (PST) or Anesthetic Bladder Challenge (ABC). Those given the PST were queried afterward regarding the tolerability of the test. Of 3883 patients initially surveyed, 13.1% (n +/- 509) reported PUF scores suggestive of probable IC, including 17.5% (357 of 2043) of women and 8.3% (152 of 1840) of men. Overall, 4.3% (168 of 3883) of patients in this primary care population was diagnosed with IC on the basis of history, PUF score, patient interview, and results of the PST or ABC. The PST was found to be comparable to, and in most cases less painful than, several standard office-based procedures. IC is a prevalent disease in the general primary care population. The PUF questionnaire represents an easy-to-use approach for IC symptom screening, and the PST and the ABC are useful and relatively noninvasive adjuncts in the diagnosis of IC.
 ...
PMID:Prevalence of interstitial cystitis in a primary care setting. 1746 79

Emerging data are changing the pelvic pain paradigm for gynecologic patients. Historically, interstitial cystitis (IC) was rarely considered as a cause of chronic pelvic pain (CPP), but recent data suggest that IC is a common cause of CPP in gynecologic patients and perhaps is even the most common cause. It is important to consider the bladder as a generator of symptoms early in the evaluation of the gynecologic patient with CPP. New tools have been developed to aid the gynecologist in ruling out IC in patients with CPP, including a new IC symptom questionnaire and the Potassium Sensitivity Test (PST). By determining whether the pain is of bladder origin, the physician can more successfully treat the patient with CPP.
 ...
PMID:The emerging presence of interstitial cystitis in gynecologic patients with chronic pelvic pain. 1746 81

The traditional diagnosis of interstitial cystitis (IC) only recognizes the severe form of the disease. The far more common early and intermittent phases of the disease are not perceived to be part of IC but rather are misdiagnosed as urinary tract infection, urethral syndrome, overactive bladder, chronic prostatitis, urethritis, or a type of gynecologic pelvic pain (such as endometriosis, vulvodynia, or some type of vaginitis). All of these patient groups actually suffer from the same bladder disease. This disease results from a leaky bladder epithelium and subsequent potassium leakage into the bladder interstitium that generates the symptoms of frequency, urgency, pain or incontinence in any combination. Robust scientific data now support this important concept. These data will be reviewed herein. The conclusions derived from these data substantially alter the paradigms for urology and gynecology in the generation of frequency, urgency and pelvic pain. All the above-mentioned syndromes unite into one primary disease process, lower urinary dysfunction epithelium, or LUDE disease, and not the 10 plus syndromes traditionally recognized.
 ...
PMID:The role of a leaky epithelium and potassium in the generation of bladder symptoms in interstitial cystitis/overactive bladder, urethral syndrome, prostatitis and gynaecological chronic pelvic pain. 2117 78

The key to successful therapy of interstitial cystitis (IC) is to correctly diagnose it. The significant majority of patients with IC have a dysfunctional bladder epithelium that allows urinary solutes (primarily potassium) to leak into the bladder wall, causing symptoms and tissue damage. Drugs that correct this dysfunction and suppress symptoms are important to achieve successful outcomes in patients. Today over 95% of females with IC are misdiagnosed as having gynecologic chronic pelvic pain, vulvodynia, vaginitis, endometriosis, overactive bladder or urinary tract infection. Men are misdiagnosed as having prostatitis. Often children are not diagnosed at all. Multimodal drug therapy may be required and can achieve successful resolution of IC in over 90% of patients. IC in children can be treated successfully with pentosan polysulfate.
 ...
PMID:Diagnosing the bladder as the source of pelvic pain: successful treatment for adults and children. 2530 Mar 87


1 2 Next >>