scholarly journals A complex approach to the diagnosis and treatment of pelvic pain in women: clinical and economic aspects

2012 ◽  
Vol 93 (1) ◽  
pp. 61-67 ◽  
Author(s):  
N V Moskovenko
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Treatment Time ◽  
Economic Effect ◽  
Laboratory Data ◽  
Main Group ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Doppler Flowmetry

Aim. To improve the results of treatment of chronic pelvic pain in women secondary to chronic nonspecific salpingoophoritis and chronic cystitis. Methods. Examined were 91 women of reproductive age suffering from pelvic pain. The patients comprised two groups. The first group included 68 women in the treatment of which physical exercise therapy, electromagnetic resonance radiation and laser treatment were used. The comparison group included 23 women who received conventional therapy. Used were the generally accepted clinical and special methods of investigation: determined was the content of gonadotropic and steroid hormones, conducted were sonographic, urodynamic studies, laser Doppler flowmetry, assessed was the heart rate variability by the R.M. Baevskiy technique. The medical and psychological examination of women included a study of a women’s personality traits with the help of classical psycho-diagnostic methods. Results. Chronic pelvic pain in women is accompanied by a disturbance of the autonomic balance, increase in the activity of the regulatory systems and psychoemotional disorders, in the structure of which anxiety and depression conditions dominate. The influence of these disturbances on the major categories of quality of life has been established. After treatment was completed marked improvement was observed in the women of the main group; herein the disappearance of major symptoms, normalization of laboratory data, ultrasound investigation data, indicators of microcirculation occurred in a shorter time; the duration of treatment decreased. In the long-time registered was a decrease of the frequency of exacerbations of the disease in the main group of women by 2.6 times relative to the comparison group of patients. The economic effectiveness of the proposed methods of treatment was 40.2%. Conclusion. The usage of physiotherapy techniques in the treatment of pelvic pain made it possible to reduce the treatment time, reduce the frequency of exacerbations of the disease, to establish an economic effect.

Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

2021 ◽  
Vol 20 (4) ◽  
pp. 5-11
Author(s):  
E.A. Galliamov ◽  
◽  
L.N. Aminova ◽  
V.A. Alimov ◽  
A.G. Kozub ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Main Group ◽  
Pelvic Pain Syndrome ◽  
Deep Infiltrating Endometriosis ◽  
Rectovaginal Septum ◽  
Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

scholarly journals Results of prevention of massive postural bleeding in women with preeclampsy

2020 ◽  
pp. 37-38
Author(s):  
M.Ya. Kamilova ◽  
N. Amin-Zade
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Comparison Group ◽  
Thrombus Formation ◽  
Laboratory Data ◽  
Massive Bleeding ◽  
Main Group ◽  
Severe Preeclampsia ◽  
Reproductive Age ◽  
Significant Difference

Objective. To evaluate the effectiveness of a tranexamic acid for the prevention of critical bleeding in women with preeclampsia. Materials and methods. 31 puerperas with postpartum hypotonic bleeding. Inclusion criteria: reproductive age, severe preeclampsia, postpartum hemorrhage, volume of blood loss – 700 ml, voluntary consent to the administration of the tranexamic acid. Exclusion criteria: delivery by the caesarean section. When providing emergency care, along with other standard measures, 14 women (the main group) were injected with the tranexamic acid when blood loss reached 700 ml, 17 women (the comparison group) did not receive the tranexamic acid. Research methods: measurement of the volume of blood loss (by the calculation method and by the method of measuring blood loss), statistical analysis – comparison of populations by qualitative characteristics. Results and discussion. A bleeding with a blood loss of 700-800 ml was registered in 7 women of the main group and in 6 women of the comparison group, with a blood loss of 800-900 ml – in 6 and 4 women, with the blood loss 900-1000 ml – in 1 and 7 women, respectively. There was a significant difference in outcomes (blood loss – 900-1000 ml) depending on the use of the tranexamic acid (Fisher’s exact test – 0.04537; p<0.05). Evaluation of the strength of the relationship between the frequency of aggravation of bleeding and the use of the tranexamic acid for the prevention of massive bleeding established a relationship of average strength (Cramer’s criterion – 0.387). Pregnant women with severe preeclampsia are at risk of the developing obstetric bleeding, which is associated with secondary changes in the hemostatic system in women with preeclampsia. With obstetric bleeding in women with preeclampsia, the balance between the coagulation, anti-coagulation and fibrinolytic systems is disturbed faster. Fibrinolysis is activated faster due to the limitation of thrombus formation due to the breakdown of fibrin in thrombi and the fibrinolytic properties of the fibrin breakdown products themselves. The use of the tranexamic acid in the obstetric bleeding is justified by the antifibrinolysis effect of the drug. Further research on the use of the tranexamic acid for the prevention of massive bleeding, confirmed by laboratory data, is highly relevant. Conclusions. The use of tranexamic acid with the onset of obstetric bleeding in women with risk factors for the secondary thrombocytopathy will prevent the aggravation of coagulopathy and reduce the incidence of massive obstetric bleeding caused by a disseminated intravascular coagulation.

scholarly journals Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

2021 ◽  
Vol 18 (12) ◽  
pp. 6606
Author(s):  
Jolanta Nawrocka-Rutkowska ◽  
Iwona Szydłowska ◽  
Aleksandra Rył ◽  
Sylwester Ciećwież ◽  
Magdalena Ptak ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Pelvic Pain ◽  
Predictive Value ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
History Of Surgery ◽  
Previous Surgery ◽  
History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

Chronic pelvic pain in patients of reproductive age with endometriosis

2021 ◽  
Vol 27 (1) ◽  
pp. 46
Author(s):  
E.N. Andreeva ◽  
E.V. Sheremetyeva
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Reproductive Age

Comparative study of the efficacy of topical therapy of mixed vaginitis associated with cervicitis by combined medications

2018 ◽  
pp. 42-49
Author(s):  
V.I. Pyrohova ◽  
◽  
S.O. Shurpyak ◽  
Yu.R. Fayta ◽  
M.Y. Malachinska ◽  
...  
Keyword(s):  
Comparative Study ◽  
Comparison Group ◽  
Topical Therapy ◽  
Local Therapy ◽  
Main Group ◽  
Reproductive Age ◽  
Gardnerella Vaginalis ◽  
Pathogenic Microorganisms ◽  
Candida Spp ◽  
Vaginal Suppository

The objective: to increase the effectiveness of local therapy for recurrent nonspecific vaginitis associated with cervicitis in women of reproductive age on the basis of a comparative evaluation of combined drugs Terzhinan and Neo Penotran Forte. Materials and methods. A prospective, open comparative study included 56 women aged 27.5±2.8 years with recurrent nonspecific vaginitis and cervicitis who were randomized to the main group and comparison group. Patients of the main group (n=28) received the drug Terzhinan® (1 vaginal tablet in the evening, before bed, for 10 days). The comparison group included 28 patients who received Neo-Pentran Forte (1 vaginal suppository in the evening, before bedtime, for 10 days), one vaginal suppository containing 750 mg of metronidazole and 200 mg of miconazole nitrate. The complex clinical-paraclinical examination included the determination of the state of the vaginal microbiota using several methods in parallel: a bacterioscopy of vaginal smears stained by Gram, a bacteriological rapid method using AFGENITAL SYSTEM (Liofilchem®, Italy), real-time PCR (Florocenosis) with detection antigens of chlamydia, herpes simplex virus, human papillomavirus, trichomonads. Results. The main reason for the treatment of patients were abundant pathological discharge from the genital tract (73.2%), pruritus (37.5%) and burning (23.2%) in the vulva, pain during sexual intercourse (8.9%), while 33.9% of women expressed combined complaints. Attention was drawn to the significant frequency of dyshormonal pathology among women with recurrent cervico-vaginal infections. In the examined women, uterine leiomyoma was diagnosed (28.6%), genital endometriosis (19.6%), fibrocystic breast disease (37.5%), combined benign dyshormonal diseases of the genital organs (14.3%). About 21.4% of patients treatment of thyroid gland dysfunction (hypothyroidism). According to the comprehensive examination, in all patients of clinical groups, decompensated vaginal dysbiosis was diagnosed, which was manifested by a sharp decrease in the absence of Lactobacillus spp strains in 39.3% of patients and an increase in the number of isolated opportunistic and pathogenic microorganisms to 1011 CFU/ml with an increase in the number of microorganisms in microbial associations (from 2–3 to 5–6 conditionally pathogenic and pathogenic pathogens) in all the cases analyzed. When using the genital express system in vaginal contents, women of the main group identified Escherichia coli (17.9%), Pseudomonas spp. (10.7%), Gardnerella vaginalis (39.3%), Staphylococcus aureus (17 9%), Enterococcus faecalis (25.0%), Streptococcus Group B (10.7%), Candida spp. (46.4%), Mycoplasma spp./Ureaplasma ur. in the title > 105 (14.0%). In the comparison group, the spectrum of detected pathogenic and conditionally pathogenic microorganisms did not differ significantly from the data of the main group. 92.6% of patients in the main group had a pronounced positive clinical effect, and a positive microbiological effect was achieved in 96.4% of cases that persisted during the next two months of follow-up. Without additional prescription of antifungal agents, a positive effect was achieved in 84.6% of patients in the main group with mixed bacterial-candidiasis vaginitis at 54.5% in the comparison group. The independent recovery of the lactobacilli pool to a titer of 107–109 CFU/ml in 17.9% of patients with a lack of detection of lactobacilli before treatment. A similar effect was not observed in the comparison group. Сonclusion. In a comparative study of the results of the use of Terzhinan and Neo-Penotran Forte in monotherapy in patients with inflammatory diseases of the lower genitalia (nonspecific recurrent vaginitis and cervicitis), the high clinical and microbiological efficacy of Terzhinan has been demonstrated. Key words: mixed vaginitis, cervicitis, Terzhinan, Neo-Penotran Forte.

scholarly journals Adolescent endometriosis

2017 ◽  
Vol 6 (8) ◽  
pp. 3213
Author(s):  
Meenu P. Nanthakumar ◽  
Sendhil C. Arumugam
Keyword(s):  
Adverse Effects ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Age Group ◽  
Women Of Reproductive Age ◽  
Surgical Options ◽  
Reproductive Age Group

Endometriosis is predominantly a disease of women of reproductive age group. Endometriosis is not uncommon in adolescents. Presentation tends to focus on pain, especially intractable dysmenorrhea and chronic pelvic pain. In around 60% of patients with endometriosis symptoms start in adolscence. Pain unresponsive to treatment is the usual indication for a Laproscopy. The appearance of endometriotic lesions is different from that of adults. Medical and surgical options for treatment are available. Endometriosis may be progressive and adverse effects may go beyond pain and cause infertility.

Psychiatric Comorbidity in Women with Chronic Pelvic Pain

CNS Spectrums ◽  
2011 ◽  
Vol 16 (2) ◽  
pp. 29-35 ◽  
Author(s):  
Samantha Meltzer-Brody ◽  
Jane Leserman
Keyword(s):  
Chronic Pain ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Psychiatric Comorbidity ◽  
Multidisciplinary Treatment ◽  
Stressful Events ◽  
Reproductive Age ◽  
Pain Syndromes ◽  
Increased Risk ◽  
Chronic Pain Syndromes

AbstractChronic pain syndromes are often treatment refractory and pose an enormous burden of suffering for the individual. Chronic pelvic pain (CPP) is generally defined as noncyclic pain of at least 6 months duration and severe enough to require medical care or cause disability. CPP has been estimated to have a prevalence of 15% among women of reproductive age. Women are at increased risk for both major depression and chronic pain syndromes such as CPP, and are more likely to report antecedent stressful events, have higher rates of physical and sexual abuse, and subsequently develop posttraumatic stress disorder. High rates of sexual and physical abuse and other trauma have been shown among women with CPP, including symptoms of dyspareunia (pain during intercourse), dysmenorrhea (pain during menstruation), and vulvar pain. A detailed and comprehensive evaluation of the patient with CPP should include a thorough gynecologic exam and a full mental health assessment. Treatment of CPP must include an integrated approach targeted at both the psychiatric comorbidity and pain symptoms. A multidisciplinary treatment team offers the best chance for success with CPP, and it is critical to suggest psychiatric treatment (psychopharmacology and/or psychotherapy) in addition to traditional medical and surgical approaches.

scholarly journals Chronic pelvic pain in women of reproductive and post-reproductive age: a population-based study

2016 ◽  
Vol 21 (3) ◽  
pp. 445-455 ◽  
Author(s):  
A.A. Ayorinde ◽  
S. Bhattacharya ◽  
K.L. Druce ◽  
G.T. Jones ◽  
G.J. Macfarlane
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Population Based ◽  
Reproductive Age ◽  
Population Based Study

scholarly journals Rehabilitation complex in treatment of chronic pelvic pain syndrome and erectile dysfunction in men

2019 ◽  
Vol 20 (3) ◽  
pp. 66-71
Author(s):  
V. V. Evdokimov ◽  
Sh. R. Satybaldyev ◽  
E. Sh. Satybaldyeva
Keyword(s):  
Erectile Dysfunction ◽  
Treatment Group ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Study Objective ◽  
Prostatic Fluid

The study objective is to evaluate the effectiveness of rehabilitation complex in treatment of chronic pelvic pain syndrome in men.Materials and methods. At the Kyrgyz Scientific Research Institute of Balneology and Rehabilitation, Ministry of Health of the Kyrgyz Republic, 86 patients aged between 18 and 55 years with chronic prostatitis, chronic pelvic pain syndrome in remission and erectile dysfunction (ED) were examined. In the treatment group (n = 56), rehabilitation complex (balneotherapy, physiotherapy, ultraviolet irradiation of autologous blood, psychotherapy) was used; in the comparison group (n = 30), only standard therapy was used. Blood and urine were tested; total testosterone, luteinizing, follicle-stimulating hormones were measured; ultrasound and rheography of the prostate and penis, color Doppler ultrasonography of the penile vessels, prostatic fluid cultures, spermogram analysis were performed.Results. In the treatment group, pain syndrome was diagnosed in 52 % of patients, severe ED – in 55 %; in the comparison group, pain syndrome was diagnosed in 33 % of patients, ED – in 23 %. Ultrasound of the prostate in both groups showed diffuse changes of moderate severity. After the rehabilitation complex, all patients of the treatment group showed improvement in general condition and microscopic content of the prostatic fluid, decreased pain syndrome, dysuria, sperm viscosity, increased sperm count, number of sperm with normal morphology and motility. Rheography showed increased volume of pulse blood filling of the lower pelvic organs, venous outflow to the prostate. Frequency of severe ED decreased in the treatment group from 55 to 26 %, in the comparison group – from 23 to 16 %.Conclusion. The results show the positive effect of rehabilitation complex on chronic nonbacterial prostatitis, especially in case of improvement of erectile function.

scholarly journals Laparoscopic findings in chronic pelvic pain

2013 ◽  
Vol 1 (2) ◽  
pp. 100-102
Author(s):  
J Bajracharya ◽  
NS Shrestha ◽  
C Karki ◽  
R Saha
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Diagnostic Laparoscopy ◽  
Multidisciplinary Approach ◽  
College Teaching ◽  
Reproductive Age ◽  
Medical College ◽  
Laparoscopic Finding ◽  
Reproductive Age Group ◽  
Pelvic Congestion

Background: Chronic pelvic pain is a common problem in reproductive age group women. Diagnosis of chronic pelvic pain needs multidisciplinary approach. Diagnostic laparoscopy is one of the investigations which can help in reaching the diagnosis. Objective: To know the etiology in chronic pelvic pain. Methods: This was a descriptive study done in the Department of Obstetrics and Gynaecology of Kathmandu medical college teaching hospital from January 2010 to June 2012 (30 months). All the cases of laparoscopic surgery done for chronic pelvic pain were noted and details of these cases were analyzed regarding age, parity and laparoscopic findings. Results: Total 48 cases of Chronic Pelvic Pain underwent diagnostic laparoscopy during the study period. Mean age of cases were 33 years, ranging from 20-46yrs. Almost half of the cases 43.75% were of parity two. Laparoscopic finding was negative in 29.17% and pelvic pathology was present in 70.83% of the cases. Out of the pelvic pathology endometriosis was present in 55.88% followed by pelvic adhesions, pelvic congestion and pelvic inflammatory disease, chronic ectopic in 20.58%, 14.70%, 5.88%, 2.94% respectively. Conclusion: Diagnostic laparoscopy is a useful modality in the diagnosis of etiology and management of Chronic pelvic pain. In our study, Pelvic endometriosis was the most common pelvic pathology in cases of Chronic pelvic pain. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8146 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 100-102

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