Hormonal manipulation in women with chronic, cyclic irritable bladder symptoms and pelvic pain

2002 ◽  
Vol 186 (6) ◽  
pp. 1268-1273 ◽  
Author(s):  
Gretchen M. Lentz ◽  
Tamara Bavendam ◽  
Morton A. Stenchever ◽  
Jane L. Miller ◽  
Jackie Smalldridge
2014 ◽  
Vol 21 (5) ◽  
pp. 833-836 ◽  
Author(s):  
Bonnie Wang ◽  
Seong-Jin Moon ◽  
William C. Olivero ◽  
Huan Wang

Patients with Marfan syndrome used to succumb early in life from cardiovascular complications. With the current rapid advance in medical and surgical care, such patients may now have near-normal longevities. Consequently, rare late-life complications are emerging in these patients and represent challenges to clinicians for their diagnoses and treatments. The authors report a rare case of pelvic pain and genital prolapse from a giant presacral Tarlov cyst in a 67-year-old patient with Marfan syndrome. This 67-year-old Caucasian female presented with progressively severe pelvic pain, intermittent explosive diarrhea, and dysuria. Physical and bimanual examination demonstrated genital prolapse and a nontender, cyst-like mass fixed in the midline. She underwent ultrasound, CT, and eventually MRI evaluations that led to the diagnosis of a giant (6.7 × 6.4 × 6.6 cm) Tarlov cyst originating from the right S-2 nerve root sleeve/sacral foramen with intrapelvic extension. She underwent S1–S2 and S2–S3 laminectomy with obliteration of the Tarlov cyst using aneurysm clips. Postoperatively, her pelvic pain and bowel symptoms resolved and the bladder symptoms improved. The 3-month follow-up CT of abdomen/pelvis demonstrated resolution of the cyst. The present case illustrates that clinicians caring for elderly patients with Marfan syndrome need to increasingly recognize such unusual late-life complications. Also, these large Tarlov cysts can be simply and effectively obliterated with aneurysm clips.


2018 ◽  
Vol 36 (02) ◽  
pp. 123-135 ◽  
Author(s):  
Ioana Marcu ◽  
E. Campian ◽  
Frank Tu

AbstractInterstitial cystitis/bladder pain syndrome is an uncommon but potentially devastating pelvic pain disorder affecting both women and men. This condition is often confusable and comorbid with other pelvic pain disorders. Although our understanding of the underlying pathophysiology is growing, the exact longitudinal course by which peripheral and central aberrations involving the bladder mucosa, peripheral inflammation, and central dysregulation of bladder sensitivity create painful bladder symptoms remains an area in need of further study. Only a limited number of drugs have been approved for treatment by the Food and Drug Administration, and overall durable efficacy of the many treatments reviewed in recent American Urological Association guidelines remains suboptimal, making awareness, early diagnosis, and use of effective treatments early in the disease course, where neural changes may still be reversible, imperative.


1983 ◽  
Vol 4 (7) ◽  
pp. 212-230

Laparoscopy was performed on 140 female adolescents (aged 10 to 19 years) for chronic pelvic pain at Boston Children's Hospital Medical Center. Endometriosis (without other pelvic pathology) was encountered in 47% of these patients. Pelvic pain was both cyclic and acyclic and typically began 2.9 years after menarche. Other symptoms included irregular menses, gastrointestinal and bladder symptoms, and increased vaginal discharge. The diagnosis of endometriosis had not been made preoperatively in the majority of patients despite repeated pelvic examinations and thorough evaluation of gastrointestinal and genitourinary tracts. The most constant physical finding preoperatively was tenderness with or without cul-de-sac nodularity. Comment: Endometriosis is a disorder of the female reproductive tract characterized by the finding of endometrial tissue in locations outside the uterine cavity.


Author(s):  
Maliikarjuna Gurram ◽  
Ravichander G. ◽  
Ravi Jagirdhar ◽  
Praveen Chandra

Background: The double-J (DJ) ureteral stents is most commonly used urological procedure and is associated with complications. This study was done to analyse the complications of ureteral DJ stents, modalities of management and outcomes.Methods: The present study is a prospective observational study of patients who presented with DJ stent related complications between February 2016 and November 2017. Patients were evaluated by history, examination, urine analysis, cultures, KUB ultrasonography, abdominal roentgenogram, CT-KUB, intravenous urogram and DTPA renogram. Complications like fever, hematuria and irritable bladder symptoms were managed conservatively. Patients with stent migration underwent endoscopic removal. Combined endourological procedures were performed in single or staged manner in cases with retained DJS with encrustation.Results: Total 120 patients presented with DJ stent complications during the study period. Males were 63.3% and females 36.7%. The mean age was 31.5 years. The majority 65.33% of the stents were placed for postsurgical prophylaxis. Irritable bladder symptoms 42.5% was most common complication, followed by retained stent with encrustation 17.5%, fever 15.9%, hematuria 13.3%, stent migration 5.8% and retained sent with minimal and no encrustation 5%. Stent removal was done in 47 (39.16%) patients; all patients with retained stent, stent migration, 5 (26.3%) patients with fever and 8 (15.6%) patients with irritable bladder symptoms. Common site of encrustation was bladder alone and kidney with bladder in 5 (23.80%) patients each. The mean stent indwelling time was 3.2 years. Twenty-one (17.5%) patients required combined endourological procedures such as cystolithotripsy (CLT), ureteroscopic lithotripsy (URSL), percutaneous nephrolithotomy (PCNL) with intracorporal lithotripsy. One (4.76%) patient required nephrectomy.Conclusions: Double-J stent is an important tool to prevent and relieve obstruction. Their use must be strictly restricted to selected cases with proper documentation, counseling and close tracking. Encrustation in forgotten stents should be managed with stent removal with combined endourologic techniques.


2018 ◽  
Vol 10 (4) ◽  
pp. 208-215
Author(s):  
Lina Monten ◽  
Axel Forman ◽  
Karl-Erik Andersson

Endometriosis patients often complain about pelvic and abdominal pain with varying bowel and bladder symptoms unrelated to the location and extent of the disease. The pathophysiology can be multifactorial, but one possibility is that pelvic organ cross-talk may play a role. The aim of this review was to evaluate the scientific support for this hypothesis. A search was performed in PubMed to identify relevant experimental and clinical studies. Data achieved in animal models and clinical evidence suggest that endometriosis-related pain may implicate interactions between pelvic structures like the urinary tract, the bowel and the vagina, mediated by the autonomous nervous system. Such pelvic organ cross-talk with involvement of nerve fibre outgrowth into endometriosis lesions, peripheral sensitisation and convergence of afferent nerve fibres could be an explanation for the varying pain problems in endometriosis, but the precise mechanisms are still poorly understood. Some patients with chronic pelvic pain, including those with endometriosis, also seem to have a more general somatic, musculoskeletal hyperalgesia, indicating a potential viscero-somatic convergence. This might be due to continuous nociceptive input to the brain, resulting in changes in brain structures and finally leading to central sensitisation. Thus, pelvic organ cross-talk seems to represent a new paradigm for endometriosis-related pain with novel possibilities for the development of therapeutic strategies.


2007 ◽  
Vol 177 (4S) ◽  
pp. 33-34
Author(s):  
Daniel A. Shoskes ◽  
Chun-Te Lee ◽  
Donel Murphy ◽  
John C. Kefer ◽  
Hadley M. Wood

2007 ◽  
Vol 177 (4S) ◽  
pp. 31-31
Author(s):  
J. Curtis Nickel ◽  
Dean Tripp ◽  
Shannon Chuai ◽  
Mark S. Litwin ◽  
Mary McNaughton-Collins

Sign in / Sign up

Export Citation Format

Share Document