scholarly journals Adhesion prevention in reproductive surgery

2005 ◽  
Vol 54 (5S) ◽  
pp. 28-29
Author(s):  
A. A. Popov ◽  
T. N. Manannikova ◽  
О. G. Kirushkina ◽  
N. А. Chausova ◽  
Е. Yu. Gluchov
Keyword(s):  
Sodium Chloride ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Pelvic Surgery ◽  
Adhesion Prevention ◽  
Isotonic Solution ◽  
Heparin Administration

Introduction. Adhesion formation in abdominal cavity is one of the leading disease. Adhesion formation after pelvic surgery is the cause of ileus, sterility and chronic pelvic pain. There is no foolproof method to prevent the adhesion constitution. There are some recommendations in the literature to prevent this process: to use crystalloids and colloids after basic operative stage, dosing irrigation the cavity with isotonic solution sodium chloride with heparin, administration of the glucocorticoid.

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.

scholarly journals Superior Hypogastric Plexus Block for Chronic Pelvic Pain Through an S1 Transforaminal Approach: A Case Report

2019 ◽  
pp. 133-137
Author(s):  
Zahra Sykes
Keyword(s):  
Case Report ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Pelvic Surgery ◽  
Pelvic Pain Syndrome ◽  
Transforaminal Approach ◽  
Hypogastric Plexus ◽  
Superior Hypogastric Plexus ◽  
Plexus Block

Chronic prostatitis/chronic pelvic pain syndrome (CPPS) is a debilitating syndrome commonly seen in men under the age of 50 years, which greatly impacts the quality of life. The treatment is challenging, which often requires a multimodal management approach. The superior hypogastric plexus is located anterior to L5 and S1 vertebral bodies in the retroperitoneal space and contains afferent pain fibers from most of the pelvic structures. Performing a superior hypogastric plexus block (SHPB) can potentially alleviate pain originating from various pelvic regions and structures. It is currently a viable therapy for many syndromes including endometriosis, interstitial cystitis, irritable bowel syndrome, and pain after pelvic surgery. In this case report, we present a patient who had chronic pelvic pain with a poor response to conservative management. Initially, attempts at an SHPB from the classic posterolateral approach were unsuccessful. This technique for performing this block can prove difficult due to vasculature variability or anatomic barriers, such as the iliac crest and transverse process of the fifth lumbar vertebrae. Thus, a left S1 transforaminal approach was used to block the plexus. This provided the patient with one month of near 100% pain relief, with gradual return to baseline thereafter. CPPS poses unique treatment challenges. Although often treated conservatively, SHPB is a valid treatment option for those who fail to respond adequately to other modalities. An S1 transforaminal approach is a novel and valuable alternative technique for SHPB in patients with compromising anatomy. Key words: Chronic prostatitis, chronic pelvic pain, superior hypogastric plexus, superior hypogastric plexus block, pelvic trauma, pelvic pain in men

Postsurgical adhesion formation and prevention – recent developments with regard to the consecutive stages in adhesion formation

1996 ◽  
Vol 5 (1) ◽  
pp. 37-49 ◽  
Author(s):  
Erica A Bakkum ◽  
J Baptist Trimbos ◽  
Trudy CM Trimbos-Kemper
Keyword(s):  
Pelvic Pain ◽  
Bowel Obstruction ◽  
Chronic Pelvic Pain ◽  
Adhesion Formation ◽  
Clinical Problem ◽  
Fallopian Tubes ◽  
Sperm Transport ◽  
Recent Developments ◽  
Additional Role

The formation of adhesions is a significant clinical problem. Complications like bowel obstruction and chronic pelvic pain are known to be related to adhesion formation. Besides these complications, adhesions do play an additional role in the gynaecological patient. Interference with the functioning of the fallopian tubes and ovaries disturbs ovum pickup and sperm transport and may compromise the fertility of patients.

scholarly journals An Optimized Procedure for Non-Contrast Magnetic Resonance Imaging in the Diagnosis of Chronic Pelvic Pain in Women

2020 ◽  
Vol 101 (2) ◽  
pp. 103-112
Author(s):  
K. A. Zavylova ◽  
B. E. Shakhov ◽  
S. V. Morovov
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Abdominal Cavity ◽  
Abdominal Ultrasound ◽  
Final Diagnosis ◽  
Diagnostic Value ◽  
Lumbosacral Spine ◽  
Morphological Examination ◽  
Gynecological Examination ◽  
Mri Protocol

Objective. To optimize a pelvic and lower abdominal cavity MRI protocol in the diagnosis of chronic pelvic pain (CPP) in women.Material and methods. A total of 57 reproductive-aged women with complaints of CPP were examined. The first stage of all patients after clinical and laboratory examination for clinical indications was performed ultrasound of the pelvis and abdominal cavity with dopplerometry. In the second stage, all the patients underwent an MRI using the standard Protocol, and then a modified Protocol. The final diagnosis was based on the results of a comprehensive examination, which included a clinical and neurological examination, gynecological examination, pelvic and abdominal ultrasound, radiography of the ileosacral joints and lumbosacral spine, fibrocolonoscopy and laparoscopy with morphological examination of the operating material (according to indications).Results. Forty-six (81%) patients were found to have gynecological factors for the development of CPP; 16 (28%) had extragenital factors. The examination results were verified by the data of surgical intervention (n = 16 (28%)), hysteroscopy (n = 21 (37%)), and laparoscopy (n = 9 (16%)) with morphological examination of biopsy specimens or surgical material.Comparing with the standard pelvic MR protocol provided evidence for the high diagnostic value of the modified protocol statistically significantly (p < 0.05): 99.2% sensitivity and 99.6% specificity.Conclusion. The developed non-contrast 1.5T MRI protocol for the pelvis permits MR images of the pelvis and adjacent anatomical areas to be obtained during one study without increasing time expenditures and upgrading equipment and software. The use of the protocol makes it possible to improve the quality of radiation diagnosis of gynecological and extragenital diseases in CPP and to recommend that the protocol in combination with other clinical and instrumental studies be introduced in clinical practice.

Efficacy of Tenoxicam on Intra-Abdominal Adhesion Prevention in a Rat Model

1996 ◽  
Vol 24 (4) ◽  
pp. 352-357 ◽  
Author(s):  
T Yilmazlar ◽  
E Kaya ◽  
E Gürpinar ◽  
H Emiroğlu
Keyword(s):  
Rat Model ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Test Material ◽  
Adhesion Prevention ◽  
Control Group ◽  
Albino Rats ◽  
Abdominal Adhesion ◽  
Wistar Albino Rats ◽  
The Right

The aim of this study was to investigate the effect of tenoxicam as a non-steroidal anti-inflammatory drug (NSAID) on intra-abdominal adhesion prevention in a rat model. Altogether 50 Wistar-Albino rats weighing 220 – 280 g were assigned to five groups, each of which was made up of 10 rats. All the rats were anaesthetized and prepared for sterile surgery. After a mid-line laparotomy was performed, a 1 cm area of the caecum was rubbed with gauze until subserosal haemorrhage developed, and then a 5 mm-diameter part of the peritoneum on the right side of the abdominal wall was removed. Prior to complete closure, 3 ml of the test material was placed into the abdominal cavity. On the eighth day the rats were killed and the adhesion score was determined. The groups and their mean adhesion scores were as follows: control group (normal saline), 2.5; group of dilution buffer, 1.8; tenoxicam (0.125 mg/kg), 1.3; tenoxicam (0.25 mg/kg), 1.3; and tenoxicam (0.5 mg/kg), 0.9. The differences between the adhesion scores among all the groups ( P < 0.05, Kruskal-Wallis test), and those between the tenoxicam groups and control group ( P < 0.05, Mann-Whitney U-test), were significant. Thus a single instillation of tenoxicam into the peritoneal cavity at the time of surgery reduced adhesion formation effectively in this model, irrespective of dosage.

Female chronic pelvic pain is highly prevalent in Denmark. A cross-sectional population-based study with randomly selected participants

2014 ◽  
Vol 5 (2) ◽  
pp. 93-101 ◽  
Author(s):  
S. Loving ◽  
T. Thomsen ◽  
P. Jaszczak ◽  
J. Nordling
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Daily Life ◽  
Population Based ◽  
Reproductive Age ◽  
Pelvic Surgery ◽  
Country Of Birth ◽  
Women Of Reproductive Age ◽  
Cross Sectional ◽  
Female Population

AbstractBackground and purposeFemale chronic pelvic pain is a significant clinical problem that burdens the health care services and work productivity, and leads to disability and reduced quality of life among the women affected. A recent systematic review reported worldwide prevalence rates for female chronic pelvic pain ranging from 2.1% to 24%. Our aim was to assess the prevalence, characteristics, and factors associated with chronic pelvic pain among women living in Denmark, and to compare these findings with a pain-free reference group. Secondly, we evaluated the impact of pain on daily life in women suffering from chronic pelvic pain.MethodsA cross-sectional postal survey of the prevalence of chronic pelvic pain was undertaken in a randomly selected general female population in Denmark (N = 2500). Inclusion criteria were: (a) ≥18 years of age and (b) living in the Capital region or the region of Zealand in Denmark. Statistical analyses included prevalence percentage rates, chi-square tests, Mann–Whitney tests, and unpaired T-tests. Logistic regression analysis was used to identify the significant independent variables and to estimate their simultaneous impact on chronic pelvic pain. The results were expressed as odds ratio and 95% confidence intervals. All tests were two-tailed and significance levels were set at p < 0.05.Results1179 (48%) women living in representative areas of Denmark responded. The prevalence of chronic pelvic pain was 11% (n = 130) in women ≥18 years with a prevalence of 13.6% (n = 87) in women of reproductive age; 6.2% (n = 73) women experienced at least moderate average pain intensity (numerical rating scale ≥4). Self-reported diagnosis of irritable bowel syndrome (20%), bladder pain syndrome/interstitial cystitis (3%), vulvodynia (9%), endometriosis (8%), and pelvic surgery in the preceding 6 months (5%) were more prevalent in cases compared to pain-free reference subjects (p = 0.00). Chronic pelvic pain interfered with daily life “all the time” in 5% of the women, “sometimes” in 72.3%, and “not at all” in 22.7%. Factors independently associated with chronic pelvic pain were age, country of birth, and former pelvic trauma or pelvic surgery (p < 0.05). No association was found between chronic pelvic pain and selected socio-demographic factors (residential area, educational level, cohabitation status and employment status).ConclusionsFemale chronic pelvic pain appears highly prevalent (11%) in Denmark (6.2% with moderate to severe pain). Women of reproductive age had a slightly increased prevalence (13.6%). Although the reported prevalence is based on 48% (N = 1179) of the invited sample, dropout analyses found that respondents did not deviate from non-respondents. Therefore, we considered the reported prevalence rate representative for the total sample and generalisable to the general female population in Denmark. This study was cross-sectional, and relied on association-based analyses. Consequently, causality between age groups, country of birth, former pelvic surgeries and pelvic traumas and experiences of chronic pelvic pain remains unknown.ImplicationsIn order to improve prevention and treatment of chronic pelvic pain in Denmark, high quality, population-based cohort studies and randomised clinical trials are essential. The demand for trustworthy chronic pelvic pain prevalence estimates might also inspire political attention and hereby facilitate funding for further development of treatment and research.

scholarly journals The role of diagnostic laparoscopy in gynecology

2015 ◽  
Vol 134 (1) ◽  
pp. 70-73 ◽  
Author(s):  
Raquel Togni ◽  
Cristina Laguna Benetti-Pinto ◽  
Daniela Angerame Yela
Keyword(s):  
Pelvic Pain ◽  
Medical Records ◽  
Chronic Pelvic Pain ◽  
Diagnostic Laparoscopy ◽  
Intrauterine Device ◽  
Abdominal Cavity ◽  
Tertiary Level ◽  
Adnexal Tumor ◽  
Level Hospital

ABSTRACT CONTEXT AND OBJECTIVES: Laparoscopy is a diagnostic method that is currently becoming consolidated for therapeutic use. It consists of endoscopically viewing the abdominal cavity. The aim here was to evaluate the indications for diagnostic videolaparoscopy and the intraoperative findings in an endoscopic gynecology clinic at a tertiary-level hospital over the last five years. DESIGN AND SETTING: Retrospective descriptive study on all diagnostic videolaparoscopy procedures of the last five years carried out in the endoscopic gynecology clinic of a tertiary-level hospital. METHODS: The medical records of 618 women who underwent diagnostic laparoscopy between 2008 and 2012 were analyzed. The clinical characteristics of these women, the indications for videolaparoscopy and the intraoperative findings were evaluated. RESULTS: The women's mean age was 32 ± 6.4 years. Most of the women had already undergone at least one previous operation (60%), which was most frequently a cesarean. The indications for performing videolaparoscopy were infertility in 57%, chronic pelvic pain in 27% and others (intrauterine device, adnexal tumor, ectopic pregnancy or pelvic inflammatory disease) in 16%. The main laparoscopic findings were tubal alterations in the group with infertility (59.78%) and peritoneal alterations in the group with chronic pelvic pain (43.54%). CONCLUSION: The main indications for videolaparoscopy in gynecology were infertility and chronic pelvic pain. However, in most procedures, no abnormalities justifying these complaints were found.

Managing chronic pelvic pain following reconstructive pelvic surgery with transvaginal mesh

2013 ◽  
Vol 25 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Anthony N. Gyang ◽  
Jessica B. Feranec ◽  
Rakesh C. Patel ◽  
Georgine M. Lamvu
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Transvaginal Mesh ◽  
Pelvic Surgery ◽  
Reconstructive Pelvic Surgery

95: Incidence and Significance of Prostatic Stones in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

2007 ◽  
Vol 177 (4S) ◽  
pp. 33-34
Author(s):  
Daniel A. Shoskes ◽  
Chun-Te Lee ◽  
Donel Murphy ◽  
John C. Kefer ◽  
Hadley M. Wood
Keyword(s):  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome
Sign in / Sign up

Export Citation Format

Share Document