1/15. Effects of short-course buserelin therapy on adenomyosis. A report of two cases.BACKGROUND: hysterectomy and hysteroscopic endometrial ablation remain common treatment of symptomatic adenomyosis for women who have completed childbearing. However, for patients who wish to avoid surgery and in whom adenomyosis is suspected of causing infertility, repeated abortion or physical symptoms, medical treatment with gonadotropin-releasing hormone analogue (GnRH-a) should be considered. CASES: Two cases of documented adenomyosis were suspected of causing infertility; both were treated with a three-month course of GnRH-a via a nasal spray. Both patients experienced relief of symptoms and conceived within six months of the cessation of treatment. CONCLUSION: The efficacy and safety of a short course of GnRH-a treatment of adenomyosis may be considered in patients who take less time than others to achieve a significant reduction of uterine size and relief of symptoms and in those who develop side effects.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/15. endometriosis ascites: a case report.This is a case presentation of an usual nature, a 43-year-old Hispanic female, multigravida presenting with physical findings of massive ascites. In most instances, the presence of massive ascites is associated with malignancies, tuberculosis or perforated visous. In this case, the diagnosis of extensive endometriosis with ascites is reported as a very rare complication of the disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/15. rectus abdominis endometrioma.A 31-year-old woman presented with complaints of increasingly severe right lower quadrant discomfort that had occurred for several days each month over the course of the previous 6 months. A tender mass of the abdominal wall was palpated on physical examination, and subsequent ultrasonography and magnetic resonance imaging disclosed a discrete mass of the body of the right rectus abdominis muscle which was confirmed as endometrial tissue on biopsy. rectus abdominis endometrioma is a relatively rare cause of abdominal pain which may mimic an acute abdomen. Clinical clues to the diagnosis include previous uterine or gynecological surgery/invasive procedure (with preservation of ovarian function), cyclical nature of the discomfort, and the presence of a palpable mass with or without associated skin color changes.- - - - - - - - - - ranking = 8.7549339941231keywords = physical examination, physical (Clic here for more details about this article) |
4/15. 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 = 8.7549339941231keywords = physical examination, physical (Clic here for more details about this article) |
5/15. Neuropathic uterine pain after hysterectomy. A case report.BACKGROUND: Neuropathic pain arises when there is damage to or dysfunction of the nervous system. Diabetic neuropathy, postherpetic neuralgia and phantom limb pain are common types of neuropathic pain. It is not commonly recognized in gynecologic practice. CASE: A patient underwent a hysterectomy for a tuboovarian abscess and underlying endometriosis. Despite maximal dosing with conventional pain medications, she continued to have significant pain that had not been present following prior surgeries. Use of low-dose amitriptyline successfully treated the pain, with no sequelae. CONCLUSION: Persistent pain following gynecologic surgery that does not respond to conventional therapy may have a neuropathic origin. attention to appropriate history and physical examination may lead to an increase in the diagnosis of neuropathic pain in gynecology patients. This may have implications for persistent pain in other gynecologic diseases.- - - - - - - - - - ranking = 8.7549339941231keywords = physical examination, physical (Clic here for more details about this article) |
6/15. Laparoscopic appendectomy in a female patient with situs inversus: case report and literature review.BACKGROUND: situs inversus is an uncommon condition caused by a single autosomal recessive gene of incomplete penetration. A potential diagnostic dilemma can occur in the young female patient with a history of situs inversus who presents with pelvic pain. methods: A 32-year-old multiparous patient with a known history of situs inversus presented with complaints of pelvic pain. A medical history and full physical examination were indicative of possible endometriosis. RESULTS: The patient underwent an operative laparoscopy, which revealed stage II pelvic endometriosis based on the American Fertility Society Revised classification for endometriosis (R-AFS), with appendicular and periappendicular adhesions involving the cecum. Ablation of endometriosis and an appendectomy were performed. CONCLUSION: The authors believe the laparoscopic approach to an appendectomy is ideal in a patient with situs inversus and should be performed at the time of laparoscopy performed for another reason.- - - - - - - - - - ranking = 8.7549339941231keywords = physical examination, physical (Clic here for more details about this article) |
7/15. endometriosis presenting as a urethral diverticulum: a case report.BACKGROUND: pelvic pain is a common complaint among women of childbearing age. It has an extensive differential diagnosis that at times can make it difficult to determine its etiology. One must therefore rely on the characteristics of the physical examination, symptoms and imaging studies. However, in doing so, one should keep in mind that many diseases mimic one another. physicians must be careful not to fall into the trap of simply assigning a specific disease to a given group of symptoms. CASE: A 35-year-old woman, gravida 2, para 0020, presented to a clinic complaining of left lower abdominal pain. She had a history of dyspareunia, dysmenorrhea, urinary frequency and numerous urinary tract infections. Previous laparoscopies had been negative for endometriosis. Physical examination demonstrated a 1.5-cm mass left of the midurethra. No pus was expressed through the urethra with cyst massage. Imaging showed a 1.1 x 1.1-cm lesion in the left posterolateral aspect of the urethra consistent with a urethral diverticulum. Uterine adenomyosis was also noted. Although clinical symptoms, physical examination and imaging suggested a urethral diverticulum, a vaginal endometriotic cyst was encountered at surgery. Pathologic evaluation of the surgically excised lesion revealed endometriosis, revealed endometriosis. CONCLUSION: In this case, clinical findings, location and imaging characteristics of a periurethral endometriotic lesion suggested a urethral diverticulum. endometriosis should be considered in patients with a history of pelvic pain who present with urinary frequency and a periurethral lesion.- - - - - - - - - - ranking = 17.509867988246keywords = physical examination, physical (Clic here for more details about this article) |
8/15. Pseudohypertestosteronemia during danazol therapy. A case report.Several steroid radioimmunoassay kits, particularly testosterone, cross-react with danazol, producing false elevations of serum steroid levels. A patient taking danazol simultaneously developed signs of virilization and an apparent 15-fold elevation in her serum testosterone. Discontinuation of danazol resulted in a prompt return to physical and biochemical normality.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/15. Urinary tract endometriosis.Although endometriosis is a common gynecologic pathologic phenomenon, involvement of the urinary tract is relatively rare. The clinical presentation and course of urinary system disease is extremely variable, as illustrated by the seven cases presented in this report. Therapy primarily is surgical, but a thorough understanding of the disease process and a complete knowledge of the patient's history and desires for fertility conservation are necessary to plot the most appropriate treatment course. Bladder involvement is more common, and usually less devastating, than either ureteral or kidney involvement. No signs, symptoms, or physical findings are pathognomonic, and the clinician must maintain a high index of suspicion in all cases of advanced pelvic endometriosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/15. endometriosis.endometriosis is a common disease associated with pelvic pain and infertility. The etiology and physiology are poorly understood, often frustrating clinicians and patient. Treatment may be medical or surgical, or a combination of these. nursing care involves education of couples about endometriosis and its physical and psychological implications.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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