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chronic pelvic pain

Muhammad Shahid, Nicole Gull, Austin Yeon, Eunho Cho, Jooeun Bae, Hyun Seok Yoon, Sungyong You, Hana Yoon, Minjung Kim, Benjamin P Berman, Jayoung Kim
Interstitial cystitis (IC) is a chronic urinary tract disease that is characterized by unpleasant sensations, such as persistent pelvic pain, in the absence of infection or other identifiable causes. We previously performed comprehensive metabolomics profiling of urine samples from IC patients using nuclear magnetic resonance and gas-chromatography/mass spectrometry and found that urinary α-oxoglutarate (α-OG), was significantly elevated. α-OG, a tricarboxylic acid (TCA) cycle intermediate, reportedly functions to suppress the proliferation of immortalized normal human bladder epithelial cells...
March 14, 2018: Scientific Reports
Edward M Schaeffer
No abstract text is available yet for this article.
May 2017: Journal of Urology
Emily Aherne, Katie Beauchamp, Niamh Maher, Thomas Walsh, William Boyd, Maeve Eogan, Leo Lawler
A 32-year-old primiparous woman presented with severe abdominal pain at 21 weeks' gestation. Background history of laparoscopy for chronic pelvic pain and a spontaneous miscarriage was noted. On examination, she was peritonitic and tachycardic with low grade fever and anemia. MRI abdomen demonstrated a uterine rupture with a large cap of clotted blood overlying the uterine fundus with the appearance of a "shower cap" and large volume haemoperitoneum, the presumptive diagnosis was uterine rupture with placental extrusion...
May 2017: Ulster Medical Journal
Lewis Chan, Vincent Tse
PURPOSE: The mid-urethral synthetic sling (MUS) procedure has become the standard of care for treatment of female stress urinary incontinence. However, a small number of patients will have complications following MUS including failure, obstructive voiding, sling erosion, or chronic pain. This paper discusses the role of 2D and 3D ultrasound imaging in the evaluation of the female patient with complications following placement of a synthetic mid-urethral sling. RESULTS: The MUS is easily visualized as an echogenic structure on ultrasound and can be imaged by transperineal, transvaginal and introital approaches...
March 12, 2018: World Journal of Urology
Takayuki Arai, Miki Fuse, Yusuke Goto, Kanya Kaga, Akira Kurozumi, Yasutaka Yamada, Sho Sugawara, Atsushi Okato, Tomohiko Ichikawa, Tomonori Yamanishi, Naohiko Seki
Interstitial cystitis (IC), also known as bladder pain syndrome, is a chronic inflammatory disease that affects the bladder. The symptoms of IC vary, including feeling an urgent need for immediate urination and of needing to urinate often, as well as bladder or pelvic pain. Despite its high incidence, no molecular diagnostic methods are available for IC, and the molecular pathogenesis is unknown. microRNAs (miRNA) can regulate expression of RNA transcripts in cells and aberrant expression of miRNAs is associated with several human diseases...
March 12, 2018: Journal of Human Genetics
C Huchon, G Aubry, S Ploteau, A Fauconnier
In case of consultation for chronic pelvic pain or suspicion of endometriosis, it is recommended to evaluate the pain (intensity, resonance) and to search out the evocative and localizing symptoms of endometriosis (Grade B). The main symptoms suggestive of endometriosis are: severe dysmenorrhea (NP2), deep dyspareunia (NP2), painful defecation during menstruation (NP2), urinary tract symptoms during menstruation (NP2) and infertility (NP2). In patients with chronic pelvic pain, it is recommended to search deep infiltrating endometriosis in patients with painful defecation during menstruation or severe deep dyspareunia (Grade B)...
March 9, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
John Jarrell
Historically, the evolutionary origins of menstruation have been based on two theories: the ability to eliminate infectious agents carried to the uterus with spermatozoa and the comparative conservation of energy with menstruation compared to its absence. In the menstruating species, more recent theories have identified spontaneous decidualization as the key adaptive mechanism. Spontaneous decidualization is seen as a mechanism to provide the mother with protection from the invasive characteristics of the embryo...
February 8, 2018: Best Practice & Research. Clinical Obstetrics & Gynaecology
P-A Bolze, P Paparel, F Golfier
Urinary tract involvement by endometriosis is reported in 1% of endometriosis patients (NP3). Consequences range from pelvic pain for bladder localizations to silent kidney loss in case of chronic ureteral obstruction (NP3). The feasibility of laparoscopic management was widely proven (NP3) and may reduce hospital stay length (NP4). Radical surgery with partial cystectomy for bladder localizations was shown to significantly and durably reduce pain symptoms with low risk of a severe postoperative complications (NP3)...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Adel Sedrati, Amal Drizi, Bruno van Herendael, Dusan Djokovic
STUDY OBJECTIVE: To present and discuss the hysteroscopic aspects of incarcerated omentum through uterine perforation caused by previous dilatation and curettage (D&C) for incomplete first-trimester abortion. DESIGN: Case report. SETTING: Constantine University Hospital, Constantine, Algeria. PATIENT: A 40-year-old, G3P2 patient, with a history of an incomplete first-trimester spontaneous abortion, treated 6 months before by D&C, requiring medical assistance due to moderate, chronic pelvic pain...
March 7, 2018: Journal of Minimally Invasive Gynecology
Kurt Barnhart, Linda Giudice, Steve Young, Tracey Thomas, Michael P Diamond, James Segars, Wahid A Youssef, Stephen Krawetz, Nanette Santoro, Esther Eisenberg, Heping Zhang
OBJECTIVE: Endometriosis is a chronic, estrogen dependent condition that affects 5-10% of reproductive aged women and is associated with pelvic pain and infertility. As the approach to therapy shifts from surgical ablation to pharmacological control, a non-surgical mode of diagnosis would be desirable. The ENDOmarker study was designed by the NICHD Reproductive Medicine Network (RMN) to obtain well characterized and phenotyped bio specimens in a standardized fashion from women with and without endometriosis...
March 7, 2018: Contemporary Clinical Trials
Rachel Bonnema, Megan McNamara, Jennifer Harsh, Elizabeth Hopkins
Chronic pelvic pain in women can arise from many causes and often results in significant declines in function and quality of life. A systematic approach for evaluating patients and initiating a management plan are recommended in the primary care setting. Comprehensive management strategies may include medication, pelvic physical therapy, and behavioral interventions.
March 2018: Cleveland Clinic Journal of Medicine
Amélie Levesque, Thibault Riant, Stéphane Ploteau, Jérôme Rigaud, Jean-Jacques Labat
Background: The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient's description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP. Objective: The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
N Bourdel, P Chauvet, M Canis
In this chapter we have examined the possibilities of screening endometriosis, both in the general population as well as in the target population. We then proposed decision trees, for primary and secondary care. Currently, there is not enough data in the literature to develop or organize a screening test for endometriosis. Screening for endometriosis is not recommended in the general population (level A). There is also no evidence to support systematic screening in a population with genetic risk factors (endometriosis in a relative), or with other clinical risk factors (increased menstrual volume, short cycles, early menarche) (level A)...
March 4, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
S Ploteau, B Merlot, H Roman, M Canis, P Collinet, X Fritel
Minimal and mild endometriosis (stage 1 and 2 AFSR) can lead to chronic pelvic pain and infertility but can also exist in asymptomatic patients. The prevalence of asymptomatic patients with minimal and mild endometriosis is not clear but typical endometriosis lesions are found in about 5 to 10% of asymptomatic women and more than 50% of painful and/or infertile women. Laparoscopic treatment of minimal and mild endometriotic lesions is justified in case of pelvic pain because their destruction decrease significatively the pain compared with diagnostic laparoscopy alone...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
J-M Wattier
A major symptom of endometriosis is pelvic pain with a wide range of intensity, rhythm, type, and expression, without clearly established relationship between pain and the disease. Endometriosis-associated pain has physical, psychological/behavioral and social consequences with a significant impact on patient quality-of-life in relation with the biopsychosocial model of chronic pain. Pain assessment in all of its dimensions, as well as assessing the consequences of pain is therefore a crucial part of therapeutic management...
March 3, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Wendy S Biggs, Erin T Carey, Jeannette M McIntyre
This article reviews the limited evidence for treating chronic pelvic pain and offers recommendations for the primary care physician on providing symptomatic relief in the absence of diagnosed pathology.
March 2018: Journal of Family Practice
Vito Chiantera, Marco Petrillo, Elene Abesadze, Giulio Sozzi, Margherita Dessole, Mariano Catello Di Donna, Giovanni Scambia, Jalid Sehouli, Sylvia Mechsner
OBJECTIVE: Evaluation of clinical presentation and surgical outcome in patients with deep lateral pelvic endometriosis (dLPE). DESIGN: Retrospective multicentric study (Canadian Task Force Classification II-2). SETTING: University tertiary referral centres. PATIENTS: 148 women with deep infiltrating endometriosis (DIE). INTERVENTION: Laparoscopic excision of DIE. Disease Distribution was classified as: Central Pelvic Endometriosis (CPE) when DIE involved one of these anatomic sites: cervix, vagina, uterosacral ligaments, rectum, bladder and pelvic peritoneum; superficial Lateral Pelvic Endometriosis (sLPE) when parametria, ureters or hypogastric plexus were involved; deep Lateral Pelvic Endometriosis (dLPE) in presence of sacral plexus and/or sciatic nerve infiltration...
March 1, 2018: Journal of Minimally Invasive Gynecology
Abi Muere, Dean A Tripp, J Curtis Nickel, Kerri-Lynn Kelly, Robert Mayer, Michel Pontari, Robert Moldwin, Lesley K Carr, Claire C Yang, Jorgen Nordling
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a urologic chronic pelvic pain syndrome with suboptimal treatment outcomes. Catastrophizing is an empirically supported risk factor for greater IC/BPS pain. In this study, a moderated multiple mediation model is tested in which several additional psychosocial risk factors (depression, illness and wellness-focused behavioral coping strategies) are proposed as mediators or moderators in the existing relationship between catastrophizing and IC/BPS pain. The present questionnaire study employed a cross-sectional design...
February 28, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Olivia C Eller-Smith, Andrea L Nicol, Julie A Christianson
Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic functional disorders that are often categorized as centralized pain syndromes include fibromyalgia, chronic pelvic pain syndromes, migraine, and temporomandibular disorder. Patients often suffer from widespread pain, associated with more than one specific syndrome, and report fatigue, mood and sleep disturbances, and poor quality of life...
2018: Frontiers in Cellular Neuroscience
Omero Benedicto Poli-Neto, Carla Campos Martins Chamochumbi, Patrícia Toscano, Mônica Pitanguy Julio, Wilson Marques, Júlio César Rosa-E-Silva, Francisco José Candido-Dos-Reis, Antônio Alberto Nogueira
OBJECTIVE: This study examines the electromyography pattern of abdominal trigger points developed after a caesarean section and the association between clinical response and local anaesthetic injection. DESIGN: Prospective cohort study. SETTING: A tertiary university hospital. POPULATION: Twenty-nine women with chronic pelvic pain associated with trigger points after a caesarean section were included in the study. METHODS: Participants received needle electromyography before treatment, then underwent a treatment protocol consisting of trigger-point injection of 2 mL of 1% lidocaine...
February 27, 2018: BJOG: An International Journal of Obstetrics and Gynaecology
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