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

A primary abdominal pregnancy was discovered in a 23-year-old woman who had used a Copper-T IUD for 2 years. After complaining about pelvic pain and bleeding disorders, X-rays were taken and the IUD was located in the pelvis minor. After acute pain and bleeding symptoms, a laparotomy was performed and a 3-1/2 month pregnancy with the placenta attached to the peritoneus parietale was discovered and removed without complication. The possible relationship to the IUD perforation is discussed.
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PMID:[Abdominal pregnancy. A complication of an intrauterine coil?]. 52 8

Used endoscopically, the CO2 laser offers some advantages over other operative techniques for endometriosis and adhesions but, in spite of the continuing development of new instrumentation there are still problems with the system. The technique needs specialized equipment requiring ongoing biomedical maintenance and specialized technical care in the operating room. Some problems such as the intraperitoneal accumulation of smoke, gas leakage, and difficulty with maintenance of proper beam alignment still occur. In spite of these problems the advantages are numerous: the system allows precise bloodless destruction of diseased tissue and eliminates the risks of cautery. In the hands of an experienced laparoscopist, it appears safe and effective in vaporization of endometriotic lesions, utero-sacral neurectomy, adhesiolysis and salpingostomy. The judicious use of these techniques, combined with carefully planned further investigations by well-trained and experienced laparoscopists and continuing improvements in the delivery systems, will soon reveal the true efficacy of the CO2 laser laparoscope. If studies continue to show pregnancy rates and pain relief to be equivalent to those patients treated by laparotomy, CO2 laser laparoscopy will become the preferred procedure for the management of pelvic endometriosis and its associated adhesions, distal tubal occlusion, pelvic pain and tubal pregnancy. With the exception of using the argon laser to treat endometriosis, the selective absorption characteristic of lasers has not been greatly utilized. While the CO2 laser is heavily absorbed by water and hence vaporizes most cells in a rather indiscriminate fashion, this is not true for other wavelengths, such as argon, Nd-YAG, KTP, krypton, xenon, copper and gold vapour lasers. The energy form of each of these lasers has different properties of penetration, absorption, reflection and heat dissipation. Many of these lasers have not yet been evaluated in human subjects. An exciting, although not new, area of possible laser application involves the use of photosensitizers and fluorescing agents (Dougherty et al, 1978). Some recent experimental studies (Schellhas and Schneider, 1986; Schneider et al, 1988) may lead to new therapeutic possibilities. The surgical laser is not, however, a panacea. Only controlled trials carried out carefully over the next few years will clearly define its potential. In the meantime it is incumbent upon all of us to investigate the clinical, gynaecological and surgical applications in a careful, methodical and scientific manner.
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PMID:CO2 laser laparoscopic surgery. Adhesiolysis, salpingostomy, laser uterine nerve ablation and tubal pregnancy. 253 9

Complications associated with postabortion insertion of the Delta T and Copper T 200 IUDs were compared in 195 women. All insertions were performed with an inserter. There were no reported incidents of inserter-related problems, pelvic pain, or other complications at insertion. At follow-up, intermenstrual spotting was the most frequently reported complaint, involving 14 women (18.2%) in the Delta T group and 7 women (9.5%) in the TCu group. 8 Delta T acceptors (10.4%) and 12 TCu acceptors (16.2%) experienced intermenstrual bleeding. Intermenstrual pain was reported by 7 (9.1%) Delta T users and 4 (5.4%) TCu users. Other primary bleeding and pain complaints included menorrhagia, reported by 9 (11.7%) Delta T users and 9 (12.2%) TCu users, and dysmenorrhea, reported by 5 (6.5%) Delta T users and 4 (5.4%) TCu users. Pelvic inflammatory disease (PID) confined to the uterus was diagnosed in 9 (11.7%) Delta T acceptors and 5 (6.8%) TCu acceptors. 7 women (9.1%) in the Delta T group and 8 women (10.8%) in the TCu group reported PID confined to the adnexa. 1 woman from each group had PID confined to the uterus and adnexa and 5 TCu users reported PID beyond the uterus and adnexa. Of the 36 women diagnosed with PID, 9 had their devices removed. There was 1 pregnancy in the Delta T group and 1 device from each group was expelled. There were 3 removals for pain and bleeding in the Delta T group and 4 removals for this reason in the TCu group. The 6-month continuation rate was 85.5 for the Delta T device and 82.2 for the TCu IUD. Given the high incidence of spotting, intermenstrual bleeding, and PID recorded in this sample, insertion of an IUD in the immediate postabortion period is not recommended.
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PMID:A comparison of the delta copper T and the copper T 200 in Bologna, Italy. 372 92

An overall prevalence rate of actinomyces-like organisms (ALO) in cervical smears of IUD users of 3% (79/2734) was found, with a rate of 2% and 22.6% for copper and inert IUD users. Although the users of the inert IUDs were older, and their devices had been in situ longer, these factors did not account for the significant differences between the 2 types of IUD. 55 patients were counseled and given a leaflet on ALO. 14 IUD users with ALO positive smears who had their devices removed had mild or moderate pelvic pain or discharge. 6 others who were asymptomatic had the IUD removed at their own request. All 55 patients were reexamined 6 months-1 year later and a smear was repeated. Only 1 woman required later removal of the IUD because of dyspareunia with pelvic tenderness. After IUD removal, and without antibiotic therapy, ALO colonization was no longer found 6-12 months later in 100% (20/20) of the cases. This even included the 7 women who had had new copper IUDs inserted immediately after removal of the index device.
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PMID:Influence of removal of intrauterine contraceptive devices on colonisation of the cervix by actinomyces-like organisms. 652 11

Between April 1988 and June 1991, health workers in Nigeria followed 300 women aged 20-40 who had had a copper releasing IUD inserted during menstruation at the family planning clinic of the University College Hospital in Ibadan. The double blind clinical trial compared the effectiveness and side effects of three copper releasing IUDs: Copper T380A, Multiload 375, and Multiload 250. 75.7% had used no contraception before admission to the study. Pelvic inflammatory disease (PID) occurred more often in the MLCU 250 group than the other two groups. Only two women were hospitalized for PID. These two women used the TCU 380A or MLCU 250. Many IUD users experienced abdominal pain during menstruation and TCU 380A users had the highest rate (27% vs. 21-24%). Heavy bleeding during menstruation was more common in TCU 380A and MLCU 375 users (5% and 4%, respectively, vs. 2%). Pelvic pain/cramps were present in 1-3% of women, but did not contribute to removal. The only case of uterine perforation was in a user of the TCU 380A. None of the MLCU 375 users experienced IUD expulsion, while two TCU 380A users experienced total expulsion and two and one MLCU 250 users experienced total and partial expulsion, respectively. PID was related to IUD removal at 6 months (3.1% vs. 0; p 0.05). The pregnancy rate at 6 months was 1.1% for the TCU 380A group and 0 for the other groups. At 12 months, it was 1.1% for the TCU 380A group and the MLCU 375 group and 0 for MLCU 250. The net 6-month IUD cumulative termination rate was highest in the TCU 380A group (11.1% vs. 3-7%; p 0.05). These differences were no longer significant at 12 months. The net 6- and 12-month IUD continuation rate was 97% and 92% for MLCU 375 compared to 88.9% for TCU 380A and 93% for MLCU 250 and 85.8% for TCU 380A and 87% for MLCU 250, respectively. These findings suggest that these three IUD devices could be used in the hospital's family planning clinic.
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PMID:Performances of copper T 380A and multiload copper 375/250 intrauterine contraceptive devices in a comparative clinical trial. 749 2

The clinical performance of the Copper T 380A (TCu 380A) and the Copper T 220C (TCu 220C) intrauterine devices (IUDs) were evaluated for 12 months in a group of women who had one of the two IUDs inserted. Results are from a randomized clinical trial conducted at four collaborating research sites located in two developing countries. The gross cumulative life-table pregnancy rate of the TCu 380A IUD was found to be lower than that of the TCu 220C IUD at 12 months (0.3 and 0.8, respectively), although this difference was not statistically significant (p > 0.05). Statistically significant differences between the two study IUDs were not found with regard to IUD expulsion or IUD removal due to bleeding/pain, personal reasons, medical reasons, or planned pregnancy. No statistically significant differences were observed in the frequency of experiencing menstrual disturbances (i.e., dysmenorrhea, intermenstrual pelvic pain or intermenstrual bleeding) between the two IUD groups. These data suggest that the TCu 380A and TCu 220C IUDs are both appropriate options for contracepting women. The TCu 380A IUD, however, may be a more appropriate option for those women wishing to space births over a longer period of time.
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PMID:Clinical performance of the TCu 380A and TCu 220C IUDs in four developing country family planning clinics. 785 51

The clinical performance of the Copper T380A (TCu380A) and the Multiload 250 (MLCu250) intrauterine devices (IUDs) were evaluated for 12 months in a group of women who had one of the two IUDs inserted. Results are from a randomized clinical trial conducted at four collaborating research sites located in three developing countries. The gross cumulative life-table pregnancy rate of the TCu380A IUD was significantly lower than the rate with the MLCu250 IUD at 12 months (0.5 and 1.2, respectively, p < 0.01). No statistically significant differences between the two study IUDs were found with regard to IUD expulsion or IUD removal due to bleeding/pain, personal reasons, medical reasons, or planned pregnancy. TCu380A IUD users were more likely to report experiencing increased dysmenorrhea (p < 0.01) or intermenstrual pelvic pain (p < 0.01) than were MLCu250 IUD users. However, few of these users discontinued use of their assigned IUD because of having experienced menstrual bleeding disturbances or intermenstrual pelvic pain. These data indicate that the TCu380A IUD may be a better option than the MLCu250 IUD for women wishing to practice highly effective long-term birth control without having to resort to hormonal methods.
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PMID:Contraceptive efficacy of the Copper T380A and the Multiload Cu250 IUD in three developing countries. 794 61

In the mid-1980s in Brazil, health workers randomly assigned 1711 women aged 15-48 requesting IUD insertion at the Center for Research on Integrated Maternal and Child Care clinic in Rio de Janeiro to have the Copper-T 200 IUD inserted by a physician or by a nurse. The study aimed to determine whether trained nurses could perform as safe and effective IUD insertions as physicians. Insertion failure was more common when performed by nurses than physicians (3.3% vs. 1.3%; p = 0.005). Severe pain at insertion was more common during physician insertions than nurse insertions (10.8% vs. 7.1%; p = 0.008) and in women who had menstrual bleeding, bleeding, dysmenorrhea, or pelvic pain than in women lacking these preinsertion symptoms (14.2% vs. 7.8%; p 0.001). History of pelvic inflammatory disease (PID) or a sexually transmitted disease (STD) increased the likelihood of severe pain at insertion (14.5% vs. 8.5%; p = 0.022). Nulliparous women were more likely to experience insertion failure than parous women regardless of provider, especially for nurse insertions (11.6% vs. 1.6%; p 0.01). The higher failure rate among nurses was probably due to a higher proportion of nulliparous women in the nurse insertion group (17.2% vs. 13.6%; p 0.05). The overall IUD use-effectiveness rate at 12 months was 98.8% (98.6% for physicians and 99% for nurses). The cumulative IUD continuation rate at 12 months was slightly better for nurse insertions than for physician insertions (75.2% vs. 74.4%). There were no significant differences between termination rates regardless of reason (pregnancy, expulsion, or removal) between physicians and nurses. The increases in complaint rates between preinsertion and postinsertion were the same for both physicians and nurses (25.8% and 25.1%, respectively). These results indicate the need to emphasize taking the client's medical history and diagnosing existing medical symptoms that are possibly linked to IUD insertion complications. Physicians or more experienced nurses should insert an IUD in nulliparous women. More counseling and care are needed for women with IUD insertion complications and those with a history of PID or STD.
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PMID:Comparative study of safety and efficacy of IUD insertions by physicians and nursing personnel in Brazil. 852 Jun 6

A randomized clinical trial conducted at collaborating research sites in Peru, Nigeria, and Turkey found no significant differences between the performance of the Copper T 380A (TCu 380A) IUD and the Lippes Loop at 12 months post-insertion. The Lippes Loop is one of the few unmedicated IUDs still in use in developing countries, while the TCu 380A is steadily gaining in favor because of its longer effective life-span. Included in the analysis were 356 TCu 380A acceptors and 354 Lippes Loop users. The accidental pregnancy rate was 0.7/100 women-months of exposure for the TCu 380A and 2.1/100 for the Lippes Loop (p = 0.25); the expulsion rates were 3.5% and 6.7%, respectively, and the discontinuation rates were 15.6% and 15.8%, respectively. More women in the TCu 380A group (18.8%) than in the Lippes Loop group (14.3%) reported genitourinary tract infection during the 12-month study period, but this difference was not significant (p = 0.15). In addition, a nonsignificantly greater number of women in the former group (36.9%) than the latter group (31.8%) experienced dysmenorrhea, intermenstrual bleeding, or intermenstrual pelvic pain (p = 0.20). These findings are generally consistent with previous research.
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PMID:Clinical performance of the TCu 380A and Lippes Loop IUDs in three developing countries. 852 10

Menstrual problems and side effects associated with long-term Copper T 380A use in perimenopausal women were investigated in a follow-up study of 50 Thai women who had the IUD inserted after 40 years of age (average, 44.2 years) and used the device for at least 36 months. All study participants had their IUD inserted at the family planning clinic of the Faculty of Medicine, Chulalongkorn University, in Bangkok, Thailand, and were followed at 6-month intervals. Their average parity was 2 live births. The numbers of women with irregular menstrual cycles at 12, 24, and 36 months after IUD insertion were 7 (14%), 11 (22%), and 15 (30%), respectively. Intermenstrual bleeding and pelvic pain--the most common side effects--were experienced by 15 (30%) and 9 (18%) women, respectively, during 36 months of follow up. No pregnancies, pelvic inflammatory disease, or IUD expulsions occurred and there were no significant changes in body weight or blood pressure. These findings suggest that TCu 380A use is both safe and effective up to menopause.
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PMID:Menstrual problems and side effects associated with long-term TCu 380A IUD use in perimenopausal women. 969 3


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