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Pelvic adhesions

Kelsey L Shnaekel, Michael P Wendel, Nader Z Rabie, Everett F Magann
Objective: The aim of this review was to describe the risk factors, clinical and radiographic criteria, and management of this rare complication of pregnancy. Methods: A PubMed, Web of Science, and CINAHL search was undertaken with no limitations on the number of years searched. Results: There were 60 articles identified, with 53 articles being the basis of this review. Multiple risk factors have been suggested in the literature including retroverted uterus in the first trimester, deep sacral concavity with an overlying sacral promontory, endometriosis, previous abdominal or pelvic surgery, pelvic or uterine adhesions, ovarian cysts, leiomyomas, multifetal gestation, uterine anomalies, uterine prolapse, and uterine incarceration in a prior pregnancy...
October 2016: Obstetrical & Gynecological Survey
Nicole Yoder, Reshef Tal, J Ryan Martin
BACKGROUND: Ectopic pregnancy is the leading cause of maternal morbidity and mortality during the first trimester and the incidence increases dramatically with assisted-reproductive technology (ART), occurring in approximately 1.5-2.1 % of patients undergoing in-vitro fertilization (IVF). Abdominal ectopic pregnancy is a rare yet clinically significant form of ectopic pregnancy due to potentially high maternal morbidity. While risk factors for ectopic pregnancy after IVF have been studied, very little is known about risk factors specific for abdominal ectopic pregnancy...
October 19, 2016: Reproductive Biology and Endocrinology: RB&E
Yuichiro Kizaki, Tomonori Nagai, Ken Ohara, Yosuke Gomi, Taichi Akahori, Yoshihisa Ono, Shigetaka Matsunaga, Yasushi Takai, Masahiro Saito, Kazunori Baba, Hiroyuki Seki
BACKGROUND: While ovarian mature cystic teratomas are benign ovarian germ-cell tumors and the most common type of all ovarian tumors, the formation of fistulas into surrounding organs such as the bladder and the intestinal tract is extremely rare. This report documents a case of ovarian mature cystic teratoma with a rectal fistula, thought to be caused by local inflammation. CASE DESCRIPTION: A pelvic mass was diagnosed as an ovarian mature cystic teratoma of approximately 10 cm in diameter on transvaginal ultrasound and magnetic resonance examinations...
2016: SpringerPlus
Anar Gojayev, Diana P English, Matthew Macer, Masoud Azodi
Background. Pelvic inflammatory disease (PID) rarely results in diffuse ascites. Severe adhesive disease secondary to PID may lead to the formation of inclusion cysts and even pelvic peritoneal nodularity due to postinflammatory scarring and cause an elevation of serum CA-125 levels. The constellation of these findings may mimic an ovarian neoplasm. Case. We report a case of a 22-year-old female who presented with multiple pelvic cysts and diffuse ascites due to Chlamydia trachomatis infection. The initial gynecologic exam did not reveal obvious evidence of PID; however, a positive Chlamydia trachomatis test, pathologic findings, and the exclusion of other etiologies facilitated the diagnosis...
2016: Case Reports in Obstetrics and Gynecology
Maria L Breser, Ruben D Motrich, Leonardo R Sanchez, Virginia E Rivero
BACKGROUND: Experimental autoimmune prostatitis (EAP) is an autoimmune inflammatory disease of the prostate characterized by peripheral prostate-specific autoimmune responses associated with prostate inflammation. EAP is induced in rodents upon immunization with prostate antigens (PAg) plus adjuvants and shares important clinical and immunological features with the human disease chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: EAP was induced in young NOD, C57BL/6, and BALB/c male mice by immunization with PAg plus complete Freund́s adjuvant...
October 4, 2016: Prostate
Jaime Alfaro-Alfaro, María de Los Ángeles Flores-Manzur, Roberto Nevarez-Bernal, Rodrigo Ayala-Yáñez
Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits. Restrictions arise since this procedure requires power morcellation for fibroid tissue extraction. Two years ago, the Food and Drug Administration in the United States of America (FDA) issued the alert on power morcellation for uterine leiomyomas, addressing the risk of malignant cell spreading within the abdominal cavity (actual risk assessment from 1 in 360 to 1 in 7400 cases)...
2016: Case Reports in Obstetrics and Gynecology
Xiaoling Zhang, Meizhi Li, Jian Guan, Huanjun Wang, Shurong Li, Yan Guo, Mingjuan Liu
PURPOSE: To investigate the feasibility of three-dimensional MR neurography (3D MRN) for the sacral plexus using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences, and to demonstrate structural abnormalities in the pelvic nerve of women with pelvic endometriosis. MATERIALS AND METHODS: Twenty patients with pelvic endometriosis and 20 healthy controls were examined by contrast-enhanced 3D short time inversion recovery T2-weighted imaging (CE 3D STIR T2WI) SPACE sequences on 3 Tesla MRI...
September 26, 2016: Journal of Magnetic Resonance Imaging: JMRI
Beata Łój, Agnieszka Brodowska, Sylwester Ciecwiez, Iwona Szydłowska, Jacek Brodowski, Marek Łokaj, Andrzej Starczewski
INTRODUCTION: Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis. The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. MATERIALS AND METHOD: The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti-Chlamydia trachomatisIgG and IgA were measured by means ELISA immunoassays...
September 2016: Annals of Agricultural and Environmental Medicine: AAEM
S Reid, A Albert, M Bedaiwy, C Allaire
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
James Spain, Matthew Rheinboldt
Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for emergency visits and hospitalizations among young and adult female patients. Though gynecologic evaluation and sonography constitute the mainstay of diagnosis, multidetector CT imaging of the abdomen and pelvis is not uncommonly performed, often as the initial imaging modality, due to the frequently vague and indeterminate clinical presentation. As such, knowledge and attenuation to the often subtle early imaging features of PID afford the radiologist a critical chance to direct and expedite appropriate pathways of patient care, minimizing the risk for secondary complications, including infertility, ectopic pregnancy, and enteric adhesions...
September 19, 2016: Emergency Radiology
Mana Iida, Hiroshi Ishikawa, Makio Shozu
We report a case of spontaneous parasitic leiomyoma in a 30-year-old post-partum woman. A subserosal leiomyoma had been noted at the first trimester screening, and she had experienced persistent abdominal pain during her previous pregnancy. She was referred to hospital with severe abdominal pain at 7 months after delivery. We detected a homogenous solid tumor that resembled the subserosal leiomyoma but was completely detached from the uterus. On laparoscopy the vascularization of the tumor was supplied from the omentum, which was tightly adherent to the tumor...
September 19, 2016: Journal of Obstetrics and Gynaecology Research
Margarita V Revzin, Mahan Mathur, Haatal B Dave, Matthew L Macer, Michael Spektor
Pelvic inflammatory disease (PID) is a common medical problem, with almost 1 million cases diagnosed annually. Historically, PID has been a clinical diagnosis supplemented with the findings from ultrasonography (US) or magnetic resonance (MR) imaging. However, the diagnosis of PID can be challenging because the clinical manifestations may mimic those of other pelvic and abdominal processes. Given the nonspecific clinical manifestations, computed tomography (CT) is commonly the first imaging examination performed...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Nicole Ziegler, Matthias Korell, Anja Herrmann, Maya Sophie de Wilde, Luz Angela Torres-de la Roche, Angelika Larbig, Rudy Leon De Wilde
BACKGROUND: Uterine perforation is the most common complication of curettage and may result in bleeding. Therefore, urgent control of bleeding from the uterine wall perforation is necessary to avoid an emergency hysterectomy or blood transfusion, to prevent peritoneal adhesion formation, possible chronic pelvic pain, and infertility. In the present case, an active bleeding secondary to a perforation of the uterus during curettage, for diagnosis of endometrial carcinoma, was instantaneously and successfully treated with only the application of a novel modified polysaccharide powder...
2016: Journal of Medical Case Reports
Kamaljot Kaler, Simone L Vernez, Matthew Dolich
Inguinal hernia is a recognized complication of radical prostatectomy. Previous hernia repair, wound infection, midline incision, low body mass index, and preexisting or subclinical hernia contribute to the risk of inguinal hernia after radical prostatectomy. Concomitant hernia repair at the time of pelvic surgery has risks and benefits. Repair during surgery prevents future hernia-related complications and saves the need for an additional procedure. However, hernia repair at the time of radical prostatectomy includes the risk of mesh infection, postoperative pain, adhesions, lack of experience, and overall minimal risk with watchful waiting...
October 2016: Journal of Endourology
Philippe R Koninckx, Victor Gomel
The health care and the emotional cost of postoperative adhesions that frequently cause chronic pain, infertility, bowel obstruction, and repeat surgery are well known. Our understanding of the pathophysiology of adhesion formation and of its prevention has evolved from good surgical practice based on microsurgical principles, barriers to keep denuded areas separated to the prevention of mesothelial cell damage and of acute inflammation in the entire peritoneal cavity. Oxidative stress, in the surgical lesions and in the peritoneal cavity has an important role in adhesion formation by slowing down repair...
October 2016: Fertility and Sterility
Sen-Wen Teng, Huann-Cheng Horng, Chi-Hong Ho, Ming-Shyen Yen, Hsiang-Tai Chao, Peng-Hui Wang
Endometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases...
August 20, 2016: Journal of the Chinese Medical Association: JCMA
Handan Ak, Burak Zeybek, Sevcan Atay, Niyazi Askar, Ali Akdemir, Hikmet Hakan Aydin
OBJECTIVES: Pelvic organ prolapse (POP) is a major health problem that impairs the quality of life with a wide clinical spectrum. Since the uterosacral ligaments provide primary support for the uterus and the upper vagina, we hypothesize that the disruption of these ligaments may lead to a loss of support and eventually contribute to POP. DESIGN AND METHODS: In this study, we therefore investigated whether there are any differences in the transcription profile of uterosacral ligaments in patients with POP when compared to those of the control samples...
August 10, 2016: Clinical Biochemistry
Giuseppe Piccinni, Giuseppe Massimiliano De Luca, Stefano Lafranceschina, Antonio Biondi, Andrea Marzullo, Angela Gurrado, Mario Testini
Endometriosis occurs in 5%-10% of fertile women, usually in the pelvic region, such as the ovaries, uterine ligaments, pelvic peritoneum, and rectovaginal septum. A mesenteric endometriotic cyst is an exceptional observation and difficult to diagnose preoperatively. We report a case of a large mesenteric endometriotic cyst treated by laparoscopy. A 21-year-old Caucasian woman was admitted as an emergency to our Academic Hospital on the 30th day postpartum for abdominal pain and a palpable epigastric mass. A CT scan revealed a mass measuring 7...
August 11, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Kamaljot Kaler, Simone Lucia Vernez, Matt Dolich
Inguinal hernia is a recognized complication of radical prostatectomy. Previous hernia repair, wound infection, midline incision, low BMI, and preexisting or subclinical hernia contribute to the risk of inguinal hernia following radical prostatectomy. Concomitant hernia repair at the time of pelvic surgery has risks and benefits. Repair during surgery prevents future hernia-related complications and saves the need for an additional procedure. However, hernia repair at the time of radical prostatectomy includes the risk of mesh infection, post-operative pain, adhesions, lack of experience, and overall minimal risk with watchful waiting...
July 25, 2016: Journal of Endourology
Vivek Nama, Amit Patel, Joya Pawade, John Murdoch
The cause of post hysterectomy pain is frequently undiagnosed, and a presumed diagnosis of adhesions is made. Surgical division of adhesions often fails to alleviate the pain and adhesions do recur. As a result, post hysterectomy pain is seldom investigated despite being associated with a significant deterioration in the quality of life. We report a case of post hysterectomy bilateral neuroma of the autonomic nerves to the ovary that leads to significant pelvic pain. Excision of these neuromas resulted in complete resolution of pelvic pain and significant improvement in the quality of life...
July 13, 2016: Journal of Minimally Invasive Gynecology
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