1/16. endometriosis in the presacral nerve.OBJECTIVE: The authors report a case of extremely aggressive endometriosis involving a 32-year-old woman. methods: Different types of medication were used and various surgical procedures applied in order to reduce the clinical signs and symptoms. Among the surgical procedures employed was presacral neurectomy when endometriosis was identified in the presacral nerve. RESULTS: Receptor determination in the surgical piece was negative. CONCLUSIONS: The etiopathogenic and therapeutic aspects of this process are discussed.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/16. ehlers-danlos syndrome associated with multiple spinal meningeal cysts--case report.A 40-year-old female with ehlers-danlos syndrome was admitted because of a large pelvic mass. Radiological examination revealed multiple spinal meningeal cysts. The first operation through a laminectomy revealed that the cysts originated from dilated dural sleeves containing nerve roots. Packing of dilated sleeves was inadequate. Finally the cysts were oversewed through a laparotomy. The cysts were reduced, but the postoperative course was complicated by poor wound healing and diffuse muscle atrophy. ehlers-danlos syndrome associated with spinal cysts may be best treated by endoscopic surgery.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
3/16. Computed tomography-guided pudendal nerve block. A new diagnostic approach to long-term anoperineal pain: a report of two cases.OBJECTIVE: To show the value of computed tomography (CT) in selectively blocking the pudendal nerve in patients with long-term anogenital pain of uncertain etiology. We report a technique to selectively block the pudendal nerve using CT guidance in 2 patients with long-term anogenital pain. CASE REPORT: In 1 patient, a competitive cyclist, the diagnosis of pudendal neuralgia was substantiated by blocking the nerve under CT. The procedure relieved the pain for approximately 24 hours. In the other patient, pudendal nerve block produced perineal analgesia but no pain relief. Superior hypogastric plexus block relieved the pain significantly for about 4 weeks on 2 separate occasions, suggesting sympathetically maintained pain. CONCLUSION: The use of CT to guide the procedure allowed precision in performing the procedure and in making a differential diagnosis.- - - - - - - - - - ranking = 1.6keywords = nerve (Clic here for more details about this article) |
4/16. Use of acupuncture for managing chronic pelvic pain in pregnancy. A case report.BACKGROUND: Chronic pelvic pain is a health problem that affects many reproductive-age women. During reproduction the dilemma is even more challenging. The growing uterus often exacerbates pain, and treatment is limited by the effect on the fetus. A multispecialty approach and alternative medicine are often effective. Recently, the FDA announced the use of acupuncture and acupressure as officially recognized modalities for treatment of chronic pain in oncology patients. CASE: Chronic pelvic pain in a 23 year-old primigravida at 27 weeks' gestation was incapacitating on narcotics. After organic causes were ruled out, acupuncture was employed successfully. Outpatient management for the duration of the pregnancy included acupuncture and narcotics for breakthrough pain while maintaining activities of daily living. Spontaneous vaginal delivery without complications at 38 5/7 weeks produced a 3,305-g female infant. The pain resolved immediately following delivery. CONCLUSION: This case demonstrates the benefit of combined allopathic with alternative forms of medicine. With the use of acupuncture, narcotic use was limited in this gravida while adding to her quality of life by allowing her to maintain normal activity.- - - - - - - - - - ranking = 0.022892201471937keywords = organ (Clic here for more details about this article) |
5/16. Microlaparoscopic conscious pain mapping in the evaluation of chronic pelvic pain: a case report.Chronic pelvic pain is a debilitating, life-altering syndrome that negatively affects a woman's quality of life and personal relationships. Many women continue to suffer with pelvic pain despite having undergone multiple medical and surgical treatments. Unfortunately, some women are incorrectly labeled as having psychological illness when organic disease may be present. I report a case of a woman who underwent multiple pelvic and abdominal surgeries before the cause of her pain was identified through microlaparoscopic conscious pain mapping.- - - - - - - - - - ranking = 0.022892201471937keywords = organ (Clic here for more details about this article) |
6/16. Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients.Treatment of chronic pelvic pain (CPP), interstitial cystitis (IC), prostatodynia, and irritative voiding symptoms can be frustrating for both patients and physicians. The usual approaches do not always produce the desired results. We found that when we treated myofascial trigger points (TrP) in pelvic floor muscles as well as the gluteus, piriform, infraspinatus, and supraspinatus muscles, symptoms improved or resolved. Various palpation techniques were used to isolate active myofascial TrPs in these muscles of four patients with severe CPP, IC, and irritative voiding symptoms. Injection and stretch techniques for these muscles were performed. Visual twitch responses at the skin surface and in the muscles were used to verify successful needle piercing of a TrP. The patients were asked to verbally describe exactly where the flash of distant pain was felt, a process that permitted an accurate recording of the precise pattern of pain referred by that TrP. The findings involved with the four patients substantiate the need for myofascial evaluation prior to considering more invasive treatments for IC, CPP, and irritative voiding symptoms. Referred pain and motor activity to the pelvic floor muscles (sphincters), as well as to the pelvic organs, can be the sole cause of IC, CPP, and irritative voiding dysfunction and certainly needs further investigation.- - - - - - - - - - ranking = 0.022892201471937keywords = organ (Clic here for more details about this article) |
7/16. Midgut carcinoid tumor identified from a metastasis in the uterosacral ligament.Chronic pelvic pain is common in women of reproductive age and accounts for more than 40% of all laparoscopic procedures. In up to 40% of these patients laparoscopic findings are negative. As a result, many gynecologists frequently excise portions of the uterosacral ligaments and biopsy inconspicuous pelvic lesions in an effort to perform uterosacral nerve ablation and also to identify subclinical endometriosis. During diagnostic laparoscopy for chronic intermittent pelvic and abdominal pain, a 37-year-old woman was noted to have an incidental, 5-mm, pink-white nodule in the right uterosacral ligament. Pathologic examination reported features typical of a carcinoid tumor. Further evaluation by computerized tomographic scan and indium-III octreotide scan identified a 1.6-cm lesion in the mesentery. At laparotomy a 2-cm primary mucosal tumor in the terminal ileum and a 2-cm nodule in the adjacent mesentery were present. carcinoid tumor was confirmed in 2 nodules and in 7 of 17 mesenteric lymph nodes. liver and lung metastases were not seen.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
8/16. Sacral neuromodulation for chronic pain conditions.Some of the pelvic pain syndromes seem to have features of neurogenic inflammation and neuropathic pain in common. As opposed to being separate disease entities, they may represent a spectrum of clinical presentations of CRPS I of the pelvis. Sacral nerve root stimulation provides good symptomatic relief of pain and voiding dysfunction. The techniques of retrograde root stimulation may offer superior results with fewer complications and lead migrations when compared with other methods. Perhaps neuromodulation should be used earlier in the treatment paradigm for these disorders, before the potentially injurious procedures of hydrodistention, bladder installations, and cystectomies.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
9/16. Free-floating organized fat necrosis: rare presentation of pelvic mass managed with laparoscopic techniques.Free-floating intraperitoneal pelvic masses are exceedingly rare. These abnormalities, typically composed of organized fat necrosis, are most commonly thought to occur after spontaneous torsion and subsequent infarction of an appendix epiploica. Most of these loose bodies are incidentally discovered. Surgical removal is recommended because cross-sectional imaging typically cannot accurately make the diagnosis. laparoscopy offers a minimally invasive tool to simultaneously inspect the abdominal cavity, assess the pelvic mass diagnosis, and treat the patient. We describe the case of a patient followed up for pudendal neuropathy in which organized fat necrosis was diagnosed and treated by laparoscopy.- - - - - - - - - - ranking = 0.13735320883162keywords = organ (Clic here for more details about this article) |
10/16. Migration of an intrauterine contraceptive device to the sigmoid colon: a case report.BACKGROUND: copper T intrauterine devices (IUDs) remain the mainstay of family planning measures in developing countries, but have been associated with serious complications such as bleeding, perforation and migration to adjacent organs or omentum. Although perforation of the uterus by an IUD is not uncommon, migration to the sigmoid colon is extremely rare. Here, we report a case of migration of an IUD to the sigmoid colon. CASE REPORT: A 40-year-old woman who had an IUD (copper T), inserted 1 month after delivery, presented, 7 months later, with secondary amenorrhea and transient pelvic cramps. Clinical findings and ultrasonographic examinations of the patient revealed an 8-week pregnancy, while laboratory tests were normal. Transvaginal ultrasonography also visualized the IUD located outside the uterus, near the sigmoid colon, as if it were attached to the bowel. The pregnancy was terminated at the patient's wish; a diagnostic laparoscopy was performed concomitantly, which showed bowel perforation owing to the migration of the IUD. The device, which was partially embedded in the sigmoid colon, was removed via laparoscopy; however, because of bowel perforation, laparotomy was performed to open colostomy. CONCLUSIONS: This case report highlights the continuing need for intra- and postinsertion vigilance, since even recent advances in IUD technique and technology do not guarantee risk-free insertion.- - - - - - - - - - ranking = 0.022892201471937keywords = organ (Clic here for more details about this article) |
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