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

The factors associated with 137 cases of IUD expulsion or early removal due to complications were investigated in a case-control study conducted at an Italian family planning clinic. The 454 controls were women who did not experience adverse IUD outcomes. Complications in the study group included: bleeding (35%), expulsion (13%), pregnancy (13%), pelvic pain (15%), and pelvic inflammatory disease (24%). The majority of complications occurred 6-12 months after IUD insertion. Previous IUD use and the type of IUD inserted were unrelated to outcome. Most significant in terms of outcome was parity. There was a statistically significant (p .001) difference between the percentage of nulliparae in the study group (34%) compared with the control group (17%). Although most of the nulliparae in the study group were under 20 years of age, age did not have a significant correlation with IUD outcome. Pelvic inflammatory disease was significantly more prevalent in women under 30 years of age, while excessive bleeding was more common in cases above this age.
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PMID:Failure in intrauterine contraception. Analysis of 137 cases of unfavourable outcome. 158 53

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

1 out of 4-5 women develop uterine leiomyomata, the most common solid pelvic tumors in women. This paper assesses the reports of 4714 myomectomies and records of 59 personal cases. Townsend et al. suggested that leiomyomata are unicellular in origin. Estrogen, growth hormone, and progesterone may influence the growth of the tumors. In the performance of myomectomy, the 2 major technical concerns are the minimization of blood loss and the prevention of postoperative adhesions. Although most leiomyomata are asymptomatic and grow slowly, 20-50% of the tumors are estimated to produce symptoms, the severity of which depends upon the number, size, and location of the tumors. The symptoms include menorrhagia, infertility, fetal wastage, pelvic pain/pressure, polycythemia, ascites, impingement, and related complications (e.g., ulceration and infection, fever, pain, uterine inversion, sarcomatous change). Asymptomatic patients with uteri of less than 10-12 weeks' gestational size require no more than observation at 6-month intervals regardless of fertility status. For women with uteri of 10-12 weeks gestational size or longer, management will depend on the patient's desire for fertility. Women desirous of fertility should have a 6-12 month trial for conception. If tumor growth is rapid, myometomy may be performed earlier. Women not desirous of fertility (e.g., pre- and post-menopausal) should have total abdominal hysterectomy and bilateral salpingo-oophorectomy. For symptomatic patients desirous of fertility, myomectomy using the transabdominal approach or hysteroscopy should be performed. For symptomatic patients not desiring fertility, dilatation and curettage and hysterectomy should be performed. With regard to oral contraceptive use, no studies have yet demonstrated that women on oral pills are at increased risk for growth of these tumors. Low-dose contraceptives should not be contraindicated in patients with leiomyomata if they desire to use this form of contraceptive. With IUD users, the device should be discontinued if bleeding occurs.
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PMID:Uterine leiomyomata: etiology, symptomatology, and management. 702 95

Urinary tract infection (UTI) is the most common infection experienced by humans after respiratory and gastro-intestinal infections, and also the most common cause of both community-acquired and nosocomial infections for patients admitted to hospitals. For better management and prognosis, it is mandatory to know the possible site of infection, whether the infection is uncomplicated or complicated, re-infection or relapse, or treatment failure and its pathogenesis and risk factors. Asymptomatic bacteriuria is common in certain age groups and has different connotations. It needs to be treated and completely cured in pregnant women and preschool children. Reflux nephropathy in children could result in chronic kidney disease; otherwise, urinary tract infections do not play a major role in the pathogenesis of end-stage renal disease. Symptomatic urinary tract infections occur most commonly in women of child-bearing age. Cystitis predominates, but needs to be distinguished from acute urethral syndrome that affects both sexes and has a different management plan than UTIs. The prostatitis symptoms are much more common than bacterial prostatic infections. The treatment needs to be prolonged in bacterial prostatitis and as cure rates are not very high and relapses are common, the classification of prostatitis needs to be understood. The consensus conference convened by National Institute of Health added two more groups of patients, namely, chronic prostatitis/chronic pelvic pain syndrome and asymptomatic inflammatory prostatitis, in addition to acute and chronic bacterial prostatitis. Although white blood cells in urine signify inflammation, they do not always signify UTI. Quantitative cultures of urine provide definitive evidence of UTI. Imaging studies should be done 3-6 weeks after cure of acute infection to identify abnormalities predisposing to infection or renal damage or which may affect management. Treatment of cystitis in women should be a three-day course and if symptoms are prolonged, then a seven day course of antibiotics should be given. Selected group of patients benefits from low-dose prophylactic therapy. Upper urinary tract infection may need in-patient treatment. Treatment of acute prostatitis is 30-day therapy of appropriate antibiotics and for chronic bacterial prostatitis a low dose therapy for 6-12 months may be required. It should be noted that no attempt should be made to eradicate infection unless foreign bodies such as stones and catheters are removed and correctable urological abnormalities are taken care of. Treatment under such circumstances can result only in the emergence of resistant organisms and complicate therapy further.
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PMID:Approach to urinary tract infections. 2053 47

The objective was to describe clinical findings and pain patterns following the provocation by activities of daily living (ADL) in women suffering from pregnancy-related post-natal pelvic pain 6-12 months after delivery. Forty-one informants answered questionnaires regarding pain characteristics in respect to 14 different ADL. All informants had bilateral pain, and typically it was described as an aching pain in the areas of the posterior superior iliac spines and in the symphyseal region. Running was the most provocative activity, followed by domestic work and by activities involving pushing and pulling. Duration of the activity had a great impact on the tolerance for all activities, and for the majority of the women, menstruation and ovulation caused an exacerbation of the symptoms.
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PMID:Clinical findings, pain descriptions and physical complaints reported by women with post-natal pregnancy-related pelvic girdle pain. 2080 46

Caesarean section (CS) results in the occurrence of the phenomenon 'niche'. A 'niche' describes the presence of a hypoechoic area within the myometrium of the lower uterine segment, reflecting a discontinuation of the myometrium at the site of a previous CS. Using gel or saline instillation sonohysterography, a niche is identified in the scar in more than half of the women who had had a CS, most with the uterus closed in one single layer, without closure of the peritoneum. An incompletely healed scar is a long-term complication of the CS and is associated with more gynaecological symptoms than is commonly acknowledged. Approximately 30% of women with a niche report spotting at 6-12 months after their CS. Other reported symptoms in women with a niche are dysmenorrhoea, chronic pelvic pain and dyspareunia. Given the association between a niche and gynaecological symptoms, obstetric complications and potentially with subfertility, it is important to elucidate the aetiology of niche development after CS in order to develop preventive strategies. Based on current published data and our observations during sonographic, hysteroscopic and laparoscopic evaluations of niches we postulate some hypotheses on niche development. Possible factors that could play a role in niche development include a very low incision through cervical tissue, inadequate suturing technique during closure of the uterine scar, surgical interventions that increase adhesion formation or patient-related factors that impair wound healing or increase inflammation or adhesion formation.
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PMID:Why do niches develop in Caesarean uterine scars? Hypotheses on the aetiology of niche development. 2640 16