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Cyclic pelvic pain in female

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
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
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
R Angotti, F Molinaro, A L Bulotta, E Bindi, E Cerchia, M Sica, M Messina
Herlyn-Werner-Wunderlich syndrome (HWWS) is a rare congenital mullerian anomaly consisting of uterus didelphys, hemivaginal septum, and unilateral renal agenesis [1,2]. Most authors reported cases of Herlyn-Werner-Wunderlich syndrome with prepuberal or postpuberal onset with cyclical abdominal pain and a vaginal mass (3-8). Only six cases are reported in Literature with early onset of this syndrome under 5 years (9-14). Our case is about 3 years old girl, with all the features of this syndrome who came to our attention for lower abdominal mass...
2015: International Journal of Surgery Case Reports
E Berner, E Qvigstad, A K Myrvold, M Lieng
OBJECTIVE: To evaluate the effectiveness of total laparoscopic hysterectomy compared with laparoscopic supracervical hysterectomy for alleviating dysmenorrhoea. DESIGN: Randomised blinded controlled trial. SETTING: Norwegian university teaching hospital. SAMPLE: Sixty-two women with dysmenorrhoea. METHODS: Participants randomised to either total laparoscopic hysterectomy (n = 31) or laparoscopic supracervical hysterectomy (n = 31)...
July 2015: BJOG: An International Journal of Obstetrics and Gynaecology
Rafael M Moroni, Wellington P Martins, Rui A Ferriani, Carolina S Vieira, Carolina O Nastri, Francisco José Candido Dos Reis, Luiz Gustavo Brito
BACKGROUND: Uterine fibroids (also known as leiomyomas) are the most common benign pelvic tumours among women. They may be asymptomatic, or may be associated with pelvic symptoms such as bleeding and pain. Medical treatment of this condition is limited and gonadotropin-releasing hormone (GnRH) analogues are the most effective agents. Long-term treatment with such agents, however, is restricted due to their adverse effects. The addition of other medications during treatment with GnRH analogues, a strategy known as add-back therapy, may limit these side effects...
2015: Cochrane Database of Systematic Reviews
Kristie A Greene, Renee Bassaly, Catherine M Lynch
BACKGROUND: Imperforate hymen is a rare gynecological disorder that can lead to a number of short-term and even long-term complications. CASE: A 14-year-old girl presented complaining of fecal frequency and urgency for over 1 year. On examination she was found to have an imperforate hymen. CONCLUSION: Although often diagnosed in association with cyclic monthly pelvic pain, we present a case in which imperforate hymen presented with fecal frequency and urgency...
January 2015: Journal of Reproductive Medicine
I Alkatout, J-H Egberts, L Mettler, M Doniec, T Wedel, K-P Jünemann, T Becker, W Jonat, T Schollmeyer
Endometriosis is the second most common benign female genital disease after uterine myoma. This review discusses the interdisciplinary approach to the treatment of deep infiltrating endometriosis. Endometriosis has been defined as the presence of endometrial glands and stroma outside the internal epithelial lining of the cavum uteri. As a consequence, endometriosis can cause a wide range of symptoms such as chronic pelvic pain, subfertility, dysmenorrhea, deep dyspareunia, cyclical bowel or bladder symptoms (e...
February 27, 2015: Zentralblatt Für Chirurgie
Konstantinos A Zorbas, Konstantinos P Economopoulos, Nikos F Vlahos
PURPOSE: Recurrence of endometriosis after conservative surgery has been observed in 40-50 % of patients within the first 5 years. A variety of regimens such as combined oral contraceptives, GnRH agonists, danazol, and progestins have been used postoperatively to reduce recurrence rates. Oral contraceptives (oCP) have been used either in a cyclic or in a continuous (no pill-free interval) fashion. The purpose of this article was to summarize the existing evidence on the efficacy and patient compliance for the use of oCP in a continuous versus cyclic fashion following conservative surgery for endometriosis...
July 2015: Archives of Gynecology and Obstetrics
Sumit Ranjan Pramanik, Saumen Mondal, Sayanti Paul, D Joycerani
Endometriosis is a functional endometrial tissue found outside the normal uterine cavity. Primary umbilical endometriosis is defined as the presence of ectopic endometrial glands and stroma within umbilicus, without prior history of pelvic endometriosis. It is a rare presentation in all cases of endometriosis, especially in Asians. Here, a case of primary umbilical endometriosis has been reported in a 33-year-old nulliparous female who presented with the history of cyclical bleeding and pain in an umbilical mass during menstrual cycle...
October 2014: Journal of Human Reproductive Sciences
Jamila Alessandra Perini, Jessica Vilarinho Cardoso, Plínio Tostes Berardo, Rosane Vianna-Jorge, Luiz Eurico Nasciutti, Marta Bellodi-Privato, Daniel Escorsim Machado, Mauricio Simões Abrão
BACKGROUND: Endometriosis is regarded as a complex and heterogeneous disease in which genetic and environmental factors contribute to the phenotype. The Vascular Endothelial Growth Factor (VEGF) plays important roles in the pathogenesis of endometriosis. The present study was aimed at investigating the contribution of VEGF polymorphisms as risk factors for the development of endometriosis. This is the first study to evaluate the combined influence of the five most common VEGF polymorphisms...
2014: BMC Women's Health
Jeffrey A Steinberg, David D Gonda, Karra Muller, Joseph D Ciacci
Intramedullary spinal cord hematomas are a rare neurosurgical pathological entity typically arising from vascular and neoplastic lesions. Endometriosis is an extremely rare cause of intramedullary spinal cord hematoma, with only 5 previously reported cases in the literature. Endometriosis is characterized by ectopic endometrial tissue, typically located in the female pelvic cavity, that causes a cyclical pain syndrome, bleeding, and infertility. In the rare case of intramedullary endometriosis of the spinal cord, symptoms include cyclical lower-extremity radiculopathies and voiding difficulties, and can acutely cause cauda equina syndrome...
November 2014: Journal of Neurosurgery. Spine
Sergio Podgaec, Denise Frediani Barbeiro, Bárbara Yasmin Gueuvoghlanian-Silva, Patrick Bellelis, Maurício Simões Abrão, Edmund Chada Baracat
Endometriosis is a benign gynecological disease that is related to immune response alterations. T regulatory cells modulate immune response, and Foxp3 seems to be the best marker of these cells. This study evaluated Foxp3 mRNA expression in eutopic endometrium from women with endometriosis and healthy controls, and its expression in deep rectosigmoid endometriosis lesions, one of the more aggressive types of the disease. Foxp3 expression was higher in lesions than in eutopic endometrium in the two groups. Moreover, eutopic endometrium Foxp3 expression of women with endometriosis was associated with chronic pelvic pain and cyclic urinary pain...
October 2014: Journal of Reproductive Immunology
Daniel Paramythiotis, George Stavrou, Stavros Panidis, Dimitris Panagiotou, Kyriakos Chatzopoulos, Vasileios N Papadopoulos, Antonios Michalopoulos
INTRODUCTION: Endometriosis affects 3 to 10 percent of women of reproductive age. Most of the time it involves the pelvis; however, sites of endometriosis have been reported almost anywhere in the body. Appendiceal and primary umbilical endometriosis are considered rare loci, making accurate diagnosis elusive. Here we present the case of a 46-year-old woman with concurrent appendiceal and umbilical endometriosis. CASE PRESENTATION: A 46-year-old Greek woman presented with a large mass in the lower abdomen adhering to the surrounding organs...
2014: Journal of Medical Case Reports
K Sugihara, Y Kobayashi, A Suzuki, N Tamura, K Motamedchaboki, C-T Huang, T O Akama, J Pecotte, P Frost, C Bauer, J B Jimenez, J Nakayama, D Aoki, M N Fukuda
Endometriosis is a common gynaecological disease associated with pelvic pain and infertility. Current treatments include oral contraceptives combined with nonsteroidal anti-inflammatory drugs or surgery to remove lesions, all of which provide a temporary but not complete cure. Here we identify an endometriosis-targeting peptide that is internalized by cells, designated z13, using phage display. As most endometriosis occurs on organ surfaces facing the peritoneum, we subtracted a phage display library with female mouse peritoneum tissue and selected phage clones by binding to human endometrial epithelial cells...
2014: Nature Communications
Hussein A Zeineddine, Joseph Nassif, Yaser El-Hout, Fayez Suidan, Zeina M Saleh, Tony Bazi
INTRODUCTION AND HYPOTHESIS: Congenital vesicovaginal fistula is an exceedingly rare entity. There is no consensus regarding the nature and origin of this condition. We report two cases with congenital vesicovaginal fistula and compile previously reported cases in the English literature. Theories behind the genesis of this anomaly will be briefly presented. METHODS: We describe the presentation, diagnostic workup, and management of two patients with congenital vesicovaginal fistula...
September 2014: International Urogynecology Journal
Xinxin Li, Jennifer A Kruger, Jessica W Y Jor, Vivien Wong, Hans P Dietz, Martyn P Nash, Poul M F Nielsen
The use of synthetic polypropylene mesh for hernia surgical repair and the correction of female pelvic organ prolapse have been controversial due to increasing post-operative complications, including mesh erosion, chronic pain, infection and support failure. These morbidities may be related to a mismatch of mechanical properties between soft tissues and the mesh. The aim of this study was to gain a better understanding of the biomechanical behavior of Prolene polypropylene mesh (Ethicon, Sommerville, NJ, USA), which is widely used for a variety of surgical repair procedures...
September 2014: Journal of the Mechanical Behavior of Biomedical Materials
Michael Gruen, Alexis Laux-Biehlmann, Thomas M Zollner, Jens Nagel
BACKGROUND: Chronic pelvic pain (CPP) is defined as long-lasting and severe pelvic pain persisting over six months in cyclic or non-cyclic chronic manner. Various pathologic conditions like endometriosis, abdominal infections, intra-peritoneal adhesions or infection, underlie CPP which is often the leading symptom of the associated diseases. Pharmacological approaches addressing CPP are hampered by the absence of a straight-forward, objective, and reliable method for the assessment of CPP in rodents...
July 30, 2014: Journal of Neuroscience Methods
Kristin K Sznajder, Siobán D Harlow, Sarah A Burgard, Yanrang Wang, Cheng Han, Jing Liu
BACKGROUND: Dysmenorrhea, dyspareunia, and non-cyclic pelvic pain are health concerns for factory workers in China and may be increased by occupational stress. OBJECTIVES: To estimate the prevalence and demographic and occupational factors associated with three types of gynecologic pain among female factory workers in Tianjin. METHODS: The study included 651 female workers from three factories in Tianjin, China. Logistic regression models were estimated to determine associations between occupational stress and gynecologic pain...
January 2014: International Journal of Occupational and Environmental Health
S J Cho, T H Lee, K Y Shim, S S Hong, D E Goo
Pelvic congestion syndrome (PCS) presents with a non-cyclic pelvic pain lasting more than six months in duration in premenopausal women. Pelvic ultrasonography or computed tomography is usually the first imaging modality used to evaluate patients with suspected PCS. PCS is confirmed by visible congestion of the pelvic veins on selective ovarian venography. To our knowledge, the role of endoscopic ultrasonography (EUS) has not been reported. EUS showed multiple dilated structures especially on left side around the uterus and ovaries, which are compatible with other radiological investigations of PCS Although PCS is not typical areas within the scope of practice of endosonographers, it is useful to be familiar with the findings...
March 2014: Phlebology
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