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)

Patients with chronic pelvic pain are challenging, from both diagnostic and therapeutic viewpoints. At the pain clinic at the Medical College of Georgia School of Medicine, Augusta, we have discovered over the past 3 years that psychiatric disease is probably underrecognized in these patients and that physicians are often reluctant to discuss intimate details of a patient's sex life even though they may provide important information. In addition, sleep disorders are very prevalent. Use of vaginal-probe ultrasound may decrease the need for diagnostic laparoscopy, especially in patients without pelvic disease. In most cases, ovarian cysts in ovulating patients do not represent an abnormality. Laparoscopy and major pelvic surgery should be limited to patients with a high probability of anatomic abnormalities or persistent symptoms.
Postgrad Med 1993 Dec
PMID:Chronic pelvic pain. Differentiating anatomic from functional causes. 817 Aug 72

According to whether uterine artery treatment takes place vaginally or laparoscopically, laparoscopy for hysterectomy can be considered according to two modalities: laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH). The indications for laparoscopy are defined by the limits and/or contraindications of the vaginal route. LAVH is indicated in the following situations: pelvic pain syndrome where diagnosis and treatment can be made at the same time as hysterectomy; minimal endometriosis; past surgical history favouring adhesions formation; necessity to perform an oophorectomy; existence of an ovarian pathology. The elective indications for TLH are the severe pelvic adhesions, deep endometriosis and especially a limited vaginal accessibility associating with a narrow vagina and a fixed or non prolapsed uterus. Laparoscopy thus allows to reduce the number of laparotomies. When on overage three quarters of the hysterectomies (excluding cases of uterogenital prolapse) were up till now performed abdominally, laparoscopy could reduce this rate to approximately 10%.
Contracept Fertil Sex 1995 Dec
PMID:[Complete hysterectomy for benign pathology and laparoscopy: respective indications of laparoscopic preparation and an exclusively laparoscopic approach]. 855 73

The aim of this study is to obtain an actual survey of diagnostic and therapeutic procedures of endometriosis (EMT) in gynaecological practice in West Germany. A questionnaire was sent to 6,700 gynaecologist; 1,364 responded. Approximately 5% of all the patients in daily practice have symptoms related to EMT. Most of the patients are in their twenties. The common clinical symptoms of EMT are dysmenorrhoea (91.8%), infertility (79.7%), pelvic pain (70.9%), menstrual irregularity (46.3%), dyspareunia (21.8%) and painful defaecation (12.8%). The diagnostic standard is laparoscopy, but there are many doctors diagnosing EMT also by means of gynaecological examination (23.8%) or ultrasound (21.3%) - especially in young patients. Hormones are the first choice of therapy. Progestins and danazol are preferred. GnRH-analogues are only used by a smaller proportion of gynaecologists - particularly in infertile patients. Surgical procedures with or without hormonal suppression are another line of therapy adapted by 70.9% of the gynaecologists, which are often preferred in infertile patients. Psychological problems in EMT are caused by the uncertainties between EMT and infertility and by the difficulties between physiological menstrual discomfort and pain caused by EMT. 68.5% of the gynaecologists suggest that more information beyond diagnosis and therapy should be given to the patients. Promotion of self-supporting groups should be encouraged by the doctors.
Geburtshilfe Frauenheilkd 1995 Dec
PMID:[Endometriosis--diagnosis and therapy. Results of a current survey of 6,700 gynecologists]. 858 85

Peritoneal inclusion cysts have not received the attention they merit in the imaging literature. We present a series of peritoneal inclusion cysts and describe their sonographic features. Our findings lead us to encourage more conservative therapies. All seven patients in our series had pelvic pain and had undergone surgery previously. An ovary surrounded by septations and fluid was the most common finding by transvaginal sonography. Doppler examination showed low resistive flow in the septations. Conservative therapy was used in five cases with excellent results. We found that a confident diagnosis of peritoneal inclusion cysts is possible with ultrasonography. This diagnosis should encourage the use of more conservative therapy.
J Ultrasound Med 1995 Dec
PMID:Sonographic diagnosis of peritoneal inclusion cysts. 858 27

Ectopic pregnancy is an increasingly common and potentially catastrophic condition in which the patient often presents to the ED with abdominal pain or vaginal bleeding. Recent developments in the laboratory (sensitive beta hCG assays, progesterone assays), in ultrasonography (transvaginal probes, Doppler ultrasonography), and in the combination of modalities (discriminatory zone of beta hCG for ultrasonographic evidence of IUP) have allowed the earlier diagnosis of ectopic pregnancy, with the potential for a reduction in maternal mortality and morbidity. Understanding the strengths and limitations of the variety of diagnostic modalities available will allow the clinician to formulate a rational strategy for the early diagnosis of ectopic pregnancy. Numerous algorithms have been developed. All begin with high clinical suspicion for women of reproductive age with abdominal/pelvic pain or vaginal bleeding. Pregnancy testing with a sensitive beta hCG qualitative test is next. For stable patients found to be pregnant, sonography generally follows (often first transabdominally then transvaginally). Unstable patients require immediate resuscitation and gynecology consultation; invasive diagnostic methods may supplant laboratory studies and sonography. Unclear cases may necessitate the use of quantitative beta hCG (discriminatory zone), other pregnancy hormones (progesterone), invasive procedures (laparoscopy, culdocentesis, D&C), or observation (serial beta hCGs). A suggested algorithm incorporating these elements is shown (Fig. 1).
Acad Emerg Med 1995 Dec
PMID:Ectopic pregnancy--Part II: Diagnostic procedures and imaging. 859 21

The differential diagnosis of pelvic pain and possible injury in the female athlete is quite broad and must include gastrointestinal and genitourinary aetiologies, as well as musculoskeletal injuries. These considerations reflect the anatomical complexity of the female pelvis. The pelvic bones house the lower gastrointestinal and genitourinary viscera and transmit stress from the lower extremities to the upper body. The innervation of the pelvic structures also complicates evaluation and diagnosis when somatic and visceral afferent information affects the athlete's interpretation of pain. An algorithmic approach can facilitate evaluation and rehabilitation of pelvic injuries in the female athlete in the contest of previously described mechanisms of musculoskeletal injury.
Sports Med 1995 Dec
PMID:The evaluation of pelvic injury in the female athlete. 861 61

Changes in menstrual cycle length, menstrual duration, number of pads, dysmenorrhea and non-cyclic pelvic pain were studied in 43 women following tubal sterilization with three different techniques. One group consisted of 17 women undergoing laparotomy by Pomeroy technique; the second group consisted of 11 women undergoing laparoscopy by Fallope rings; and the third group consisted of 15 women undergoing colpotomy by fimbriectomy. The differences before and after sterilization in cycle length were non-significant in all groups (p > 0.05). After sterilization, menstrual duration and number of pads were significantly increased in the laparotomy (p < 0.001) and laparoscopy (p < 0.01) groups but non-significantly in the colpotomy group (p > 0.05). Comparison of these parameters between the groups did not show any significant differences (p > 0.05). After sterilization, increases in the severity of dysmenorrhea and non-cyclic pelvic pain were non-significant in all groups (p > 0.05). We concluded that there were no significant differences in menstrual disorders after sterilization among these three different techniques.
Adv Contracept 1995 Dec
PMID:Menstrual disorders and pelvic pain after sterilization. 865 16

The effective removal of endometriosis is the major aim of physicians treating patients with pelvic pain. This can now be accomplished long-term as effectively at laparoscopy as at laparotomy (Wheeler and Malinak, 1987; Redwine, 1991; Martin, 1994). All successful operative laparoscopists dealing with endometriosis-associated pain should be familiar with and consider offering their patients the operative procedures discussed in this chapter. Adhesiolysis is a well-accepted therapy but uterine suspension and the nerve separating techniques of LUNA and PSN are much more controversial. Pain, being subjective, is difficult to quantify and a poor end point to monitor scientifically. However, there is a significant body of published work to suggest that uterine suspension, LUNA and PSN, which have all been performed for decades, seem effective laparoscopically in reducing pelvic pain associated with endometriosis. Much more data are obviously needed to determine if endometriosis-associated pain can be effectively treated with laparoscopic procedures. Properly designed scientific prospective randomized studies to evaluate some of the laparoscopic operations discussed to treat endometriosis-associated pain have recently been reported (Sutton, 1994). Thoughtful gynaecologists dealing daily with patients with endometriosis should consider discussing with them the advantages and disadvantages of the techniques reviewed in this chapter. From our experience and that of others, it appears that adhesiolysis, uterine suspension, LUNA and PSN can all be safely and effectively accomplished by skilled laparoscopists and result in good patient outcomes. All gynaecologists involved in the care of patients with endometriosis and pain should consider learning and offering these operations to their patients with appropriate discussion of the potential risks and benefits.
Baillieres Clin Obstet Gynaecol 1995 Dec
PMID:Advanced laparoscopic procedures for pelvic pain and dysmenorrhoea. 882 Dec 56

With the aim of determining an effective therapy for adolescent women with endometriosis, the authors analyzed the results of laparotomy performed on 16 cases of female teenagers over a seven-year period. All patients, whose average age of menarche is 12.8, were diagnosed with endometriosis between two months and nine years after the menarche, with an average interval of 5.2 years. The chief symptoms are dysmenorrhea, pelvic pain and abdominal fullness. Of the three patients of unicornuate uterus with rudimentary horn, endometriosis was found only involving the adnexa on the side of the rudimentary horn, two of the three patients had absence of affected side kidney. Conservative operation including six cases of salpingo-oophorectomy and 10 cases of ovarian cystectomy were chosen followed by danazol treatment. One year to seven years after surgical treatment, two patients required subsequent conservative operation for recurrence of endometriosis and two other patients resumed dysmenorrhea. Two married women became pregnant 5 and 10 months after surgical and medical therapy respectively. In conclusion, adolescent endometriosis may occur around five years after menarche and an obstructive uterine anomaly, enhancing retrograde menstruation, increases the occurrence rate. The symptoms and treatment of endometriosis in teenage group do not really differ from that in the older women. In the treatment of endometriosis and for the prevention of recurrence, it is recommended to give three to six months of danazol after surgical treatment.
Changgeng Yi Xue Za Zhi 1995 Dec
PMID:Endometriosis in adolescent women. 885 79

As a gynecologist and analytical psychotherapist, I have been treating women suffering from severe psychosomatic gynecological dysfunctions in a semi-open psychoanalytic group since 1981. The duration of therapy is 2-3 years, and the success rate 85%. The subjective symptoms include chronic recurrent disorders of the urogenital tract in terms of urogenital resistance, chronic pelvic pain with no organic findings, pruritus vulvae, 'burning vulva' and premenstrual syndromes. These conditions are often associated with sexual dysfunctions, a disturbed experience of the body image and substantial relationship conflicts. All patients are suffering from a psychoneurosis on a broad structural basis, due psychogenetically to early unresolved triangulation.
J Psychosom Obstet Gynaecol 1996 Dec
PMID:Psychoanalytic group therapy in the treatment of severe psychosomatic dysfunctions--experiences since 1981. 899 90


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>