1/8. A systematic history for the patient with chronic pelvic pain.Chronic pelvic pain is a source of frustration to both the physician and the patient. physicians have been ill equipped by their training to confront the multifaceted nature of the complaints of patients with chronic pelvic pain. patients have experienced a repetitive dismissal of their complaints by physicians too busy in their practices to address their problems comprehensively. The approach to the patient with chronic pelvic pain must take into account six major sources of the origin of this pain: 1) gynecological, 2) psychological, 3) myofascial, 4) musculoskeletal, 5) urological, and 6) gastrointestinal. Only by addressing and evaluating each of these components by a very careful history and physical examination and by approaching the patient in a comprehensive manner can the source of the pain be determined and appropriate therapy be administered. This article was developed to provide the clinician with a set of tools and a methodology by which the patient with this complaint can be approached.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/8. Colorectal endometriosis: aggressive surgical management and practical considerations in a patient with advanced disease.The aim of this study was to evaluate the results of bowel resection in a patient with obstructive colorectal endometriosis. The presentation will acquaint the physician with the signs and symptoms, evaluation, and surgical treatment of colorectal endometriosis. We emphasize that our findings strongly support an aggressive surgical approach with resection for all visible cases of colorectal endometriosis in women with advanced disease.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/8. Endosalpingiosis as a source of psammoma bodies in a Papanicolaou smear. A case report.Psammoma bodies are concentric, laminated structures produced by cross-sectioning the tips of calcified papillary formations and are usually associated with papillary carcinoma of the thyroid gland, meningiomas and serous papillary tumors of the ovary. These structures have occasionally been seen in cytologic smears obtained from women with endometrial or ovarian carcinoma. A woman had Papanicolaou smears that continued to show psammoma bodies for over two years, eventually leading to a hysterectomy. Even though the presence of psammoma bodies on a Papanicolaou smear should always alert the physician to the possibility of ovarian carcinoma, leading to a thorough search for this malignancy, a variety of benign conditions, such as endosalpingiosis, may also be associated with this finding.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
4/8. Massive ascites associated with endometriosis in a Nigerian African.A case of endometriosis with massive ascites in a 19-year-old Nigerian African is reported. This is an unusual combination and it is likely that most gynecologists and general physicians would never see such a case. The presentation and management of this entity is discussed.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
5/8. Vesical endometriosis: medical or surgical treatment.A case report of endometriosis of the bladder is presented, with special reference to treatment options. Recent experience with this lesion illustrates the dilemma facing the physician who must determine a course of treatment. It seems that removal of the bladder lesion by segmental cystectomy is the preferred treatment.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
6/8. Obstructive uropathy associated with endometriosis.Although endometriosis involving the urinary tract is uncommon, it is responsible for considerable morbidity. A review of eight cases at two Ottawa teaching hospitals from 1979 to 1983 revealed obstructive uropathy in seven patients. There was permanent loss of kidney function in two, ovarian remnant syndrome in two, and patient and family history of renal disease in three. The diagnosis of endometriosis was not made before operation in four patients. endometriosis was localized in four patients and generalized in the remaining four, while four patients had significant uterosacral nodularity. The conclusion reached after study of this small but important population is that physicians should have a heightened awareness of this uncommon but serious manifestation of the disease. Earlier diagnosis might be achieved on the basis of a high index of suspicion and careful physical and pelvic examination. The liberal use of intravenous pyelography even in cases of minimal endometriosis is urged. Intensive and prolonged follow-up of all patients with the diagnosis of endometriosis is recommended until the menopause has been reached. Treatment of obstructive uropathy requires meticulous surgical intervention and we recommend ovarian ablation with adjuvant hormonal therapy in most circumstances.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
7/8. hemothorax after Lupron therapy of a patient with pleural endometriosis--a case report and literature review.BACKGROUND--Pulmonary endometrial implants, although uncommon, have been well described in the literature. Symptoms occur with menses and may include recurrent pleuritic chest pain, pneumothorax, hemoptysis, or hemothorax. Exacerbation of pulmonary symptoms by Lupron therapy has not been previously described. CASE REPORT--A 38-year-old African-American female with known endometriosis but no history of pulmonary disease was evaluated for a 2-year history of severe dysmenorrhea. A trial of hormonal suppression was unsuccessful, and she was offered Lupron therapy. Three weeks after its initiation, and shortly after the onset of menses, she came to the emergency room with pleuritic chest pain and shortness of breath and was found to have a right-sided hemopneumothorax. Thoracentesis treatment was successful in eliminating this symptom. CONCLUSION--Although pulmonary endometriosis is rare, physicians should be aware that Lupron therapy can exacerbate pulmonary symptoms during the initial phase of therapy.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
8/8. Intrinsic ureteric involvement by endometriosis: a case report.endometriosis occasionally involves the urinary tract, and a ureteral obstruction from this order constitutes a rare variant with serious consequences. Intrinsic ureteric involvement by endometriosis is an exceedingly rare event. This case report describes intrinsic ureteric involvement by endometriosis. The case involved 47-year-old woman, gravida 4, para 2, who had a 4-year history of dysmenorrhea and hypermenorrhea. An intravenous pyelogram showed a right hydronephrosis. She underwent a total abdominal hysterectomy and a right ureteroureterostomy. A pathologic examination revealed complete obstruction of the right ureter by intrinsic intramural endometriosis. We conclude that because ureteral endometriosis, especially intrinsic endometriosis, is usually silent and results in a high rate of renal loss before recognition, physicians should have a hightened awareness of this uncommon but serious manifestation of endometriosis.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |