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Cyclic pelvic pain

Jaya Uppal, Stanislaw Sobotka, Arthur L Jenkins
BACKGROUND: Multiple causes outside the spine can mimic spinal back pain. Endometriosis is an important gynecological disorder, which commonly affects the lower region of the female pelvis and less frequently the spine and soft tissues. The lumbosacral trunk is vulnerable to pressure from any abdominal mass originating from the uterus and the ovaries. Therefore symptoms of endometriosis include severe reoccurring pain in the pelvic area as well as lower back and abdominal pain. CASE DESCRIPTION: We report on a 39 year old gymnast with cyclic sciatica and back pain, whose initial presentation initially led to a spinal fusion at L4/5 and L5/S1, but that procedure did not change her symptoms...
October 21, 2016: World Neurosurgery
Amanda Yang Shen, Aaron Stanes
BACKGROUND: Pain associated with appendiceal endometriosis can mimic other intra-abdominal pathology. The diagnosis is usually obvious during gross inspection of the appendix; however, the absence of classical macroscopic appearances may lead to missed cases in which the patient's pain is misdiagnosed and inappropriately managed. CASE: A 34-year-old woman presented with cyclical right iliac fossa pain and an elevated serum C-reactive protein of 13 mg/L (normal < 5 mg/L)...
October 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
S Mechsner
Endometriosis is a chronic disease of women during their reproductive age. The most typical symptoms are dysmenorrhoea, dyspareunia, dysuria, cyclical and acyclical pelvic pain, bleeding disorders and infertility. These symptoms lead to significant impairment of the quality of life and economic burden. The prevalence is estimated to be 2-20 % of all women in this age and due to this fact, it is one of the most frequently benign gynecological diseases. Not all women suffer from severe symptoms, but more than 50 % require ongoing treatment...
October 2016: Der Schmerz
Letizia Zannoni, Simona Del Forno, Roberto Paradisi, Renato Seracchioli
Dysmenorrhea, cyclic pelvic pain, and acyclic pelvic pain are common in adolescent girls, and at least 10% of these girls are at risk for subsequent development of endometriosis. In this article we highlight practical tips for the management of dysmenorrhea and chronic pelvic pain and how to diagnose endometriosis as early as possible and detect patients at risk for developing the disease in the future. We suggest five practical rules for managing adolescents with dysmenorrhea and chronic pelvic pain: (1) Never underestimate the pain; (2) Always consider endometriosis as a possible cause of severe cyclic pain; (3) Obtain a detailed and accurate history before performing clinical evaluation and pelvic sonography; (4) Treat the pain with hormonal therapies (combined oral contraceptives or progestogen-only pill) and analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs); and (5) Plan frequent follow-up visits to re-evaluate the patient...
September 1, 2016: Pediatric Annals
Y Hu, X Niu, G Wang, J Huang, M Liu, B Peng
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is an independent risk factor for the development of erectile dysfunction (ED). But the molecular mechanisms underlying the relationship between CP/CPPS and ED are still unclear. The aim of this study was to investigate the effect of CP/CPPS on erectile function in a rat model and the possible mechanisms. A rat model of experimental autoimmune prostatitis (EAP) was established to mimic human CP⁄CPPS. Then twenty 2-month-old male Sprague-Dawley rats were divided into EAP group and control group...
August 27, 2016: Andrology
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
Askin Dogan, Ibrahim Uyar, Gulsah Selvi Demirtas, Atalay Ekin, Ibrahim Gulhan, Mehmet Ozeren
STUDY OBJECTIVE: Report on an unusual presentation of HHW in two 11 year old girls within a year of menarche. DESIGN: Report of two cases SETTING: Training and Research Hospital PARTICIPANT(S): Two patients in the pubertal period with cyclic abdominal pain and urinary incontinence. INTERVENTION(S): Hysteroscopic septal resection MAIN OUTCOME MEASURE(S): Menstrual flow was provided and the complaints of incontinence were eliminated following the hysteroscopic resection of the vaginal septum...
August 9, 2016: Journal of Pediatric and Adolescent Gynecology
John R Lue, Adam Pyrzak, Jennifer Allen
Endometriosis continues to be a major primary gynecologic etiology of chronic pelvic pain. The symptom profile, which includes cyclic pelvic pain, dysmenorrhea, and dyspareunia or dyschezia, is nonspecific and does not correlate with the extent or severity of disease. Trans-vaginal or trans-rectal ultrasound, as well as magnetic resonance imaging, can help visualize endometriomas and deeply infiltrating endometriosis. Additionally, there have been no serum marker tests available so far. However, even intraoperatively, the diagnosis may be missed, leading to under diagnosis and delayed or noninitiation of treatment...
April 2016: Journal of Minimal Access Surgery
Giulia Alabiso, Luigi Alio, Saverio Arena, Allegra Barbasetti di Prun, Valentino Bergamini, Nicola Berlanda, Mauro Busacca, Massimo Candiani, Gabriele Centini, Annalisa Di Cello, Caterina Exacoustos, Luigi Fedele, Eliana Fuggetta, Laura Gabbi, Elisa Geraci, Ludovica Imperiale, Elena Lavarini, Domenico Incandela, Lucia Lazzeri, Stefano Luisi, Antonio Maiorana, Francesco Maneschi, Luca Mannini, Alberto Mattei, Ludovico Muzii, Luca Pagliardini, Alessio Perandini, Federica Perelli, Serena Pinzauti, Maria Grazia Porpora, Valentino Remorgida, Umberto Leone Roberti Maggiore, Renato Seracchioli, Eugenio Solima, Edgardo Somigliana, Claudia Tosti, Roberta Venturella, Paolo Vercellini, Paola Viganò, Michele Vignali, Letizia Zannoni, Fulvio Zullo, Errico Zupi
A panel of experts in the field of endometriosis expressed their opinions on management options in a 28-year-old patient, attempting pregnancy for 1 year, with severe cyclic pelvic pain and with clinical examination and imaging techniques suggestive of adenomyosis. Many questions this paradigmatic patient may pose to the clinician are addressed, and all clinical scenarios are discussed. A decision algorithm derived from this discussion is also proposed.
May 2016: Journal of Minimally Invasive Gynecology
Julia Cambitzi, Maya Nagaratnam
Endometriosis is an enigmatic disease and its fundamental cause is still unknown. Endometriosis-associated pain syndrome is a common problem; it is underdiagnosed and patients suffering from the syndrome are rarely seen in specialist pain clinics. The correlation between the extent of the disease and pain is weak. Endometriosis-associated pain syndrome may be cyclical or persistent and the pain may radiate to other pelvic organs. Optimum treatment is timely intervention using a multidisciplinary approach.
February 2013: British Journal of Pain
C Touboul, P Amate, M Ballester, M Bazot, A Fauconnier, E Daraï
The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI)...
2013: International Journal of Chronic Diseases
Gaston Camino Willhuber, Ivan Zderic, Florian Gras, Dieter Wahl, Carlos Sancineto, Jorge Barla, Markus Windolf, Robert Geoff Richards, Boyko Gueorguiev
INTRODUCTION: Treatment of posterior pelvic ring injuries is frequently associated with pain or/and high mortality rates. Percutaneous sacro-iliac (SI) screw fixation has proved to be one of the methods of choice, providing minimal operative time, blood loss and wound-related morbidity. However, fixation failures due to secondary fracture dislocation or screw backing out have been reported. There is a little knowledge regarding the impact of varying screw orientation and quality of reduction on the fixation strength...
July 2016: International Orthopaedics
Attilio Di Spiezio Sardo, Pierluigi Giampaolino, Marianna Scognamiglio, Carlo Varelli, Giovanni Nazzaro, Gelsomina Mansueto, Carmine Nappi, Grigoris F Grimbizis
STUDY OBJECTIVE: To report the combined hysteroscopic and laparoscopic treatment of a complete septate uterus with unilateral cervical aplasia (class U2bC3V0/ESHRE/ESGE classification) and isolated mullerian remnants. DESIGN: Step-by-step presentation of the surgical treatment (Canadian Task Force classification 4). SETTING: Complete septate uterus with unilateral cervical aplasia (formally Robert's uterus) is characterized by the presence of a uterine septum completely dividing the endometrial cavity into an obstructed hemicavity and a contralateral nonobstructing hemicavity connected normally to the existing cervix...
January 2016: Journal of Minimally Invasive Gynecology
Erica D Louden, Awoniyi O Awonuga, Laura A Gago, Manvinder Singh
BACKGROUND: We present a patient with primary amenorrhea and a rare combination of anomalies. She was found to have a septate uterus, double cervix, and a longitudinal and a low transverse vaginal septum. CASE: An 18-year-old girl with primary amenorrhea presented with severe monthly pelvic pain. Examination and imaging revealed a thin transverse vaginal septum, complete septate uterus, double cervix, and a longitudinal vaginal septum. The transverse and longitudinal vaginal septa were excised and repaired...
December 2015: Journal of Pediatric and Adolescent Gynecology
Ludovico Muzii, Chiara Di Tucci, Chiara Achilli, Violante Di Donato, Angela Musella, Innocenza Palaia, Pierluigi Benedetti Panici
In the lack of evidence consistently supporting the use of continuous vs cyclic oral contraceptives after surgery for endometriosis, we conducted a systematic review and metaanalysis with the objective of comparing a continuous vs a cyclic oral contraceptive schedule administered after surgical excision of ovarian endometriomas. A PubMed, MedLine, and Embase search through December 2014 was conducted, with the use of a combination of key words and text words related to endometrioma, endometriosis, oral contraceptives, oral estroprogestins, laparoscopy, and surgery...
February 2016: American Journal of Obstetrics and Gynecology
Daniela Ulrich, Sharon L Edwards, David L J Alexander, Anna Rosamilia, Jerome A Werkmeister, Caroline E Gargett, Vincent Letouzey
BACKGROUND: Pelvic organ prolapse (POP) is a multifactorial disease that manifests as the herniation of the pelvic organs into the vagina. Surgical methods for prolapse repair involve the use of a synthetic polypropylene mesh. The use of this mesh has led to significantly higher anatomical success rates compared with native tissue repairs, and therefore, despite recent warnings by the Food and Drug Administration regarding the use of vaginal mesh, the number of POP mesh surgeries has increased over the last few years...
February 2016: American Journal of Obstetrics and Gynecology
Alessandra Graziottin
OBJECTIVES: The menstrual cycle is characterised by cyclical fluctuations in oestrogens, progesterone and androgens. Changes in hormone levels in the premenstrual phase with the decline in progesterone trigger a physiological reaction which culminates in menstruation. This process is accompanied in many women by various symptoms such as pelvic pain, headache, mood disorders and gastrointestinal discomfort. The aim of this article was to summarise the latest findings on the physiology and pathophysiology of menstruation and review the impact of shortening the hormone-free interval (HFI) on the health and wellbeing of women...
2016: European Journal of Contraception & Reproductive Health Care
Sara Azima, Hajar Rajaei Bakhshayesh, Maasumeh Kaviani, Keramatallah Abbasnia, Mehrab Sayadi
STUDY OBJECTIVE: Dysmenorrhea is the most common cyclic pelvic pain, and it affects the quality of life of many women. We sought to compare the effects of massage and isometric exercises on primary dysmenorrhea. DESIGN, SETTING, AND PARTICIPANTS: We conducted a randomized controlled trial at the dormitories of Shiraz University among 102 students with primary dysmenorrheal. INTERVENTIONS: The student groups were randomly divided into massage, isometric exercises, and control groups...
December 2015: Journal of Pediatric and Adolescent Gynecology
K C Schliep, S L Mumford, C M Peterson, Z Chen, E B Johnstone, H T Sharp, J B Stanford, A O Hammoud, L Sun, G M Buck Louis
STUDY QUESTION: What are the pain characteristics among women, with no prior endometriosis diagnosis, undergoing laparoscopy or laparotomy regardless of clinical indication? SUMMARY ANSWER: Women with surgically visualized endometriosis reported the highest chronic/cyclic pain and significantly greater dyspareunia, dysmenorrhea, and dyschezia compared with women with other gynecologic pathology (including uterine fibroids, pelvic adhesions, benign ovarian cysts, neoplasms and congenital Müllerian anomalies) or a normal pelvis...
October 2015: Human Reproduction
Murat Api, Aysen Telce Boza, Semra Kayatas, Mustafa Eroglu
BACKGROUND: Endometriosis is a complex disease with a spectrum of pain symptoms from mild dysmenorrhea to debilitating pelvic pain. There is no concrete evidence in the literature whether endometriotic cyst per se, causes pain spectrum related to the disease. The aim of the present study was to evaluate the effect of surgical removal of endome- triomas on pain symptoms. MATERIALS AND METHODS: In this prospective, observational, before-after study, which was conducted between March 2012 and January 2013 in Training and Research Hospital,Adana, Turkey, a total of 23 patients including 16 sexually active and 7 vir- gin symptomatic women were questioned for non-cyclic pelvic pain (NCPP), intensity of the NCPP, presence of cyclic dysmenorrhea, and dyspareunia before and after the endometrioma operation...
July 2015: International Journal of Fertility & Sterility
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