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Query: UMLS:C0392326 (discomfort)
 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hormonal evaluation of the infertile man can help to identify a treatable abnormality or to suggest, with a minimum of patient discomfort, that the infertility is not treatable. The need for testosterone replacement can also be determined. Impaired spermatogenesis associated with an elevated serum FSH concentration suggests primary damage to the seminiferous tubules, and a low serum testosterone concentration associated with an elevated serum LH concentration suggests primary damage to the Leydig cells. A low serum testosterone concentration associated with a serum LH concentration that is not high, on the other hand, indicates secondary hypogonadism, the result of pituitary or hypothalamic disease.
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PMID:Endocrine evaluation of the infertile male. 73 14

The authors evaluate the incidence of varicocele after having examined 18,800 healthy white men members of the Italian Army Corps born in 1966 and visited in 1985. They found a varicocele in 775 patients (4.12%), in 5 was present bilaterally, and in 770 in the left side. In 45 patients the surgical treatment was already done at the time of the examination and there were 3 recurrences. The patients with varicocele were divided according to the classification of Dubin-Amelar and were: grade I n. 175 (0.93%); grade II n. 515 (2.74%); grade III n. 35 (50.18%). In 566 (73.03%) the diagnosis was done at the moment of the examination, 152 (19.62%) discovered the varicocele at the self examination; in 57 (7.37%) the diagnosis was already done by the family doctor. Infertility is sometime associated to the varicocele and with the unrelieved local discomfort are the main indications for surgery. It should be also emphasized the need of education on the infertility problems during the high school that is a time of the life in which there is the highest incidence of varicocele.
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PMID:[Male varicocele. Analysis of the incidence of varicocele in a population of 18,800 young men]. 219 Jan 10

Hysterosalpingography provides important information in the evaluation of infertility but is generally considered an uncomfortable and painful procedure. We evaluated various analgesics for decreasing or eliminating the discomfort from this procedure. Two types of analgesia were required to give maximum pain relief during and after the examination in the 180 patients evaluated. The best results were achieved with a combination of naproxen sodium, 550 mg, given orally two hours before the examination, and 20% benzocaine, applied to the cervix.
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PMID:Pain relief in hysterosalpingography. A comparison of analgesics. 235 47

Both medical and surgical therapy have been used in the treatment of infertility associated with endometriosis. Danazol has been used following screening laparoscopy to avoid the discomfort, expense and risk of laparotomy. The CO2 laser offers the advantage of precise excisional surgery at the initial laparoscopy and thus potentially avoids further surgery and the use of danazol. In 50 infertile women in whom initial or second-look laparoscopy revealed the presence of endometriosis, CO2 laser laparoscopy was used to excise (vaporize) the endometriotic lesions. At 7-19 months of follow-up, 11 patients had become pregnant. One pregnancy was ectopic, and one aborted. The estimated long-term pregnancy rate was 60% or greater. Of those who were not yet pregnant at this writing, 59% had either a cervical factor, male factor or both. There was a 70% decrease in the use of danazol for stage I endometriosis and a 78% decrease for stage II endometriosis without a decrease in the overall pregnancy rates when compared to those for previous therapy with laparoscopic coagulation. However, the highest pregnancy rates resulted from a combination of laparoscopic laser excision and danazol.
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PMID:CO2 laser laparoscopy for the treatment of endometriosis associated with infertility. 315 92

A defective luteal phase (DLP) results from a relative deficiency in secretion of progesterone by the corpus luteum. Approximately 30% of normal women show on biopsy an occasional DLP, while only 7-14% of infertile patients have a recurrent DLP. Endometrial biopsy remains the classical way to diagnose an inadequate luteal phase. However because of the discomfort and expense associated with endometrial biopsy, attention has turned to direct measurements of plasma progesterone levels as a means to rule out an inadequate luteal phase. A single plasma progesterone level of 10 ng/ml in the luteal phase or a mean concentration of plasma progesterone of 12-13 ng/ml over 4 days at mid-luteal phase seems to exclude an inadequacy of corpus luteum function. Changes in the precise pattern of pulsatile gonadotrophin secretion (due to weight, hyperandrogenism or hyper-prolactinaemia) result in derangements of ovulatory function. For the 'essential' defective luteal phase there are as yet no controlled studies that establish either its role in infertility or the value of therapy.
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PMID:The defective luteal phase. 328 63

Thirty-eight patients with 40 varicoceles underwent spermatic venography and 27 varicoceles were treated by transvenous embolization under local anaesthesia as an outpatient procedure. The indications for the procedure were infertility (21), swelling (3), pain and discomfort (9) and asymptomatic varicoceles (5).
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PMID:Non-operative treatment of varicocele. 379 66

Six men with infertile marriages associated with poor semen and raised testicular temperature were treated by an experimental appliance which exploits evaporation to obtain normal testicular temperatures. This was worn with little discomfort for as long as 24 h a day and for periods as long as 20 weeks. Three wives became pregnant while their husbands were on treatment. Semen analysis at the time of the missed menses showed improvements in all three men. In two patients who did not achieve a pregnancy, semen improvements were also seen after 12 weeks. The improvements in semen quality cannot be attributed to any agency other than the hypothermia; this strengthens the theory that raised temperature plays a role in male infertility. Scrotal hypothermia seems to be a suitable treatment in men with varicocele, varicocelectomy failure, and idiopathic infertility where intrascrotal temperature is raised.
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PMID:Chronic scrotal hypothermia as a treatment for poor semen quality. 610 60

It is difficult to determine the true incidence of sexually transmitted diseases (STD). Underreporting of STD is widespread. In the United Kingdom the available figures exclude patients treated by general practitioners or patients in the armed forces. The incidence of STDs is rising. In 1979 the figure for the United Kingdom was about 500,000 new cases. The most common STD in England and Wales is non-specific urethritis or non-specific genital infection. The increase in gonorrhea has been less dramatic in England and Wales than it has been in other industrial and urbanized countries. Regardless, between 1960 and 1979 the incidence of the disease doubled to 60,000 new cases a year. Recent research has shown another group of sexually transmissible infectious agents which are now more common than the older venereal infections. Viruses are responsible for reversal of this 2nd generation of STDs. Their manifestations range from local discomfort to chronic disability, infertility, ectopic pregnancy, stillbirth, and neonatal death. There are many medical, social and economic factors which contribute to this increase in the incidence of STD and the recognition of the 2nd generation of sexual infections. Some of these are known, others unknown. The introduction of penicillin and other antibiotics has had a great effect on some STDs, notably syphilis. Pelvic inflammatory disease has been the most important cause of increases in female infertility and ectopic pregnancy. The new generation of STDs has serious and potentially dangerous effects on both expectant mothers and their infants.
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PMID:Biological effects of sexual freedom. 610 50

Fifty-six women with minor vaginal irritation, some associated with infertility, and with negative wet mount examination for common vaginal pathogens, used a disposable povidone-iodine-containing preparation (Betadine Medicated Douche) in a one-week trial. Of the 185 patient complaints, which included discharge, odor, pruritus, erythema, burning, and discomfort, 94 percent cleared completely and 4 percent were partially relieved. Odor cleared completely in 97 percent of affected cases and pruritus, discharge and chafing in 96, 91, and 100 percent, respectively. In all, 98 percent of the patients responded favorably. Those who became asymptomatic included women with past histories of repeated vaginal infections or on oral contraceptives, as well as a diabetic and patients with intrauterine devices. The douche caused no adverse effects and was well accepted by the patients. The present results favor short-term trial of the povidone-iodine douche in minor vaginal irritation of unknown etiology, before full laboratory investigation is undertaken.
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PMID:Short-term use of a medicated douche preparation in the symptomatic treatment of minor vaginal irritation, in some cases associated with infertility. 614 14

This paper presents the first data available on drinking and reproductive dysfunction from a representative national sample of women. In this stratified household sample of 917 women (weighted n = 2552), dysmenorrhea, heavy menstrual flow, and premenstrual discomfort increased with drinking level and were particularly strongly associated with reported consumption of 6 or more drinks a day at least once a week. Women who consumed 6 or more drinks/day at least 5 times a week had elevated rates of gynecologic surgery other than hysterectomy, but hysterectomy was less common among women averaging 2 oz or more of ethanol/day, with age effects controlled. Lifetime rates of obstetric disorders showed significant elevations at upper levels of drinking (6 or more drinks/day at least 3 times a week for miscarriage or stillbirth and prematurity, and 6 or more drinks/day at least 5 times a week for infertility and birth defects). An unexpected finding was the high rates of menstrual disorders, hysterectomy, miscarriage or stillbirth, and prematurity among temporary abstainers (women reporting alcohol consumption in the past 12 months but not the past 30 days) who had previously drunk only infrequently.
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PMID:Drinking and reproductive dysfunction among women in a 1981 national survey. 639 Dec 55


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