Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
  1. Home
  2. Search

Refine search

Refine search

Access:
Content type:
Publication date:
Apply   From and To filters
Subject: Show more
Journals Show more
Publishers: Show more
Societies Show more
Series: Show more
Collections: Show more

Actions for selected content:

Select all | Deselect all
  • View selected items
  • Export citations
  • Download PDF (zip)
  • Save to Kindle
  • Save to Dropbox
  • Save to Google Drive

Save Search

You can save your searches here and later view and run them again in "My saved searches".

Please provide a title, maximum of 40 characters.
Cancel
×

11 results

  • Chapter 24 - Sexually Transmitted Infection and Pelvic Inflammatory Disease

  • from Section 4 - Contraception and STIs
  • Edited by Tahir Mahmood, Charles Savona-Ventura, Ioannis Messinis, Sambit Mukhopadhyay
  • Book:
    The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
    Published online:
    24 November 2021
    Print publication:
    02 December 2021, pp 186-202

  • Summary

    This chapter discusses the STIs chlamydia, gonorrhoea, Trichomonas vaginalis (TV), genital warts, herpes, Mycoplasma genitalium (MG) and pelvic inflammatory disease (PID). HIV and syphilis are not covered. Chlamydia, gonorrhoea, TV, herpes and MG are diagnosed by PCR or NAAT testing. Warts and PID are predominantly diagnosed clinically. Management of all STIs involves discussion of information, both verbal and written, and advice on prevention by use of condoms and contact testing. Chlamydia, gonorrhoea, TV, MG and PID are managed by use of antibiotic regimens, which are described. Test of cure (TOC) is recommended for certain STIs (i.e. Gonorrhoea and MG) due to risk of antibiotic resistance. Treatment options during pregnancy and breastfeeding are discussed. Complications of the STIs where relevant are discussed.

  • Chapter 4 - Uterine and Tubal Causes of Infertility

  • Edited by Siladitya Bhattacharya, University of Aberdeen, Mark Hamilton, University of Aberdeen
  • Book:
    Reproductive Medicine for the MRCOG
    Published online:
    25 February 2021
    Print publication:
    25 February 2021, pp 31-42

  • Summary

    Uterine and tubal abnormalities alone or in combination with other factors are present in 17%–25% of all couples who seek care for infertility treatment. The prevalence is higher in older women and in those with secondary infertility. Although suspected at the history, it is usually confirmed by ultrasound/ laparoscopy and/or MRI depending on the cause. Multiple pathologies are identified under the umbrella of tubal and uterine factors, some are associated with infertility but very few are proven to be the only cause of infertility. Treatment depends on the condition. It ranges from no intervention to surgery to in vitro fertilisation (IVF). With advances in the technology of IVF, surgery is becoming a lost art, especially for tubal factors. Various surgical techniques have been suggested for uterine factors. Given most tubal and uterine factors have association rather than causation for infertility, the effect of surgery on improving fertility is debatable. We will discuss the causes of uterine and tubal factors, their implications on fertility, diagnostic modalities and treatment options with limitations of the available evidence. A good history and a high index of suspicion along with primary and secondary prevention of tubal and uterine factor infertility are important to prevent long-term implications.

  • Chapter 31 - Ectopic pregnancy

  • from Section 4: - Early pregnancy after infertility treatment
  • Edited by Botros R. M. B. Rizk, University of South Alabama
  • Book:
    Ultrasonography in Reproductive Medicine and Infertility
    Published online:
    07 September 2011
    Print publication:
    25 March 2010, pp 259-270

  • Summary

    Adenomyosis is a common disorder in the gynecologic population that consists of the presence of endometrial glands and stroma in the myometrium. Adenomyosis is associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and feelings of pressure low in the pelvis due to uterine enlargement. Infection of the pelvis causes pain by several different mechanisms: pelvic inflammatory disease, puerperal infections, postoperative gynecologic surgery, and abortion-related infections. Pelvic congestion syndrome (PCS) is a pelvic pain syndrome caused by retrograde flow in an incompetent ovarian vein. Symptoms associated with PCS include a shifting location of pain, deep dyspareunia, and postcoital pain, with exacerbation of symptoms after prolonged standing. Ultrasound is a very useful tool for evaluating chronic pelvic pain sufferers. Patients have better satisfaction due to their understanding of their pain, with a goal of better productivity and return to normal function.

  • Chapter 20 - Breast cancer screening

  • from Section 4 - Breast disorders
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University School of Medicine
  • Book:
    Handbook of Women's Health
    Published online:
    26 December 2009
    Print publication:
    22 October 2009, pp 215-220

  • Summary

    This chapter discusses the etiology, diagnosis and treatment of certain sexually transmitted diseases (STDs), including gonococcal (GC) infections, chlamydia infections, syphilis, genital herpes, pelvic inflammatory disease, HIV/AIDS, and hepatitis B. Gonorrhea is frequently asymptomatic in both men and women. Patients with gonococcal infections need to be evaluated for other sexually transmitted diseases, including chlamydia, HIV, hepatitis B and/or syphilis when appropriate. Neurosyphilis can occur, with symptoms of central nervous system (CNS) changes such as tabes dorsalis or dementia. All patients with syphilis should be tested for hepatitis B and HIV infections. Sex partners of women with pelvic inflammatory disease (PID) should be treated, especially to cover chlamydia and gonorrhea. Testing for HIV should be offered to all women, not just those whose behaviors may put them at risk of transmission, but to all women with an STD, including HPV.

  • Chapter 22 - Depression

  • from Section 5 - Psychological concerns
  • Edited by Jo Ann Rosenfeld, The Johns Hopkins University School of Medicine
  • Book:
    Handbook of Women's Health
    Published online:
    26 December 2009
    Print publication:
    22 October 2009, pp 239-250

  • Summary

    This chapter presents the definition, risk factors, symptoms, diagnosis and treatment of chronic pelvic pain (CPP), dysmenorrhea, and dyspareunia. The most common causes of CPP are gastrointestinal. Irritable bowel syndrome (IBS), constipation, and diverticulitis, all can cause chronic pelvic pain. Women with high stress levels have two times the risk of dysmenorrhea. A higher risk of suffering dysmenorrhea occurs in women who are overweight. Women with dyspareunia had higher pain scores and higher levels of psychological distress, low levels of marital adjustment and more problems with sexual function. Treatment of dyspareunia is based on one of the three types: insertional dyspareunia, pain in a specific location, and pain with deep penetration. Pain associated with menopausal disorders and sexual relations is common and often the presenting complaint to the physician. The case of dyspareunia may be difficult to discover but an organized approach including psychological expectations may produce improvement.

  • 1 - Ultrasound imaging in gynaecological practice

  • Edited by Davor Jurkovic, Lil Valentin, Sanjay Vyas
  • Book:
    Gynaecological Ultrasound in Clinical Practice
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 1-6

  • Summary

    This chapter provides an overview of the contribution of ultrasound examination to the evaluation of gynaecological conditions. Ultrasound imaging can be used to assess women with a history of acute or chronic pelvic pain. The imaging allows a quick non-invasive assessment of the pelvis and abdomen and it may be used as the first line investigation of patients with pelvic pain to confirm or exclude the provisional diagnosis based on clinical history. Ultrasound imaging determines the extent of ovarian and adnexal involvement in women with pelvic inflammatory disease. Ultrasound is helpful in assessing women with a history of post-menopausal bleeding and it can distinguish between women with post-menopausal bleeding who need to undergo invasive testing from those who do not require any intervention. Ultrasound is used to determine both the pregnancy location and viability. Transvaginal ultrasound has an important role in the study of female fertility.

  • 8 - Ultrasound of non-gynaecological pelvic lesions

  • Edited by Davor Jurkovic, Lil Valentin, Sanjay Vyas
  • Book:
    Gynaecological Ultrasound in Clinical Practice
    Published online:
    05 February 2014
    Print publication:
    01 June 2009, pp 77-90

  • Summary

    Transvaginal ultrasound has improved the ability of ultrasound to interrogate the pelvic organs with less interference from intervening structures such as gas or fat. The gynaecologist may need to distinguish between the symptoms caused by pelvic inflammatory disease and those of an inflamed pelvic appendix. Appendiceal mucocele occurs when there is accumulation of mucoid material within the lumen of the appendix distal to an obstruction. Mucoceles occur more commonly in women than men. Ultrasound can show different patterns, including a cystic structure with thin walls, a cyst with septations and, the most common appearance, layered rings of mucus of different echogenicity. Ultrasound is highly sensitive in detecting calculi in the kidneys. An ureterocele can be clinically silent and without upper tract dilation. The diagnosis may be made for the first time during sonography of the pelvis.

  • 9 - Pediatric and Adolescent Gynecologic Laparoscopy

  • from PART II - INFERTILITY EVALUATION AND TREATMENT
  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book:
    Infertility and Assisted Reproduction
    Published online:
    04 August 2010
    Print publication:
    15 September 2008, pp 82-90

  • Summary

    This chapter focuses on the use of laparoscopy in treatment and diagnosis of patients with pelvic pain, adnexal masses, and pelvic inflammatory disease (PID). A discussion of incidental appendectomy in these patients will also be presented. The decision to perform incidental appendectomy is based on the premise that the appendix is a vestigial, functionless organ, with the potential only to contribute to pathological change. PID can have devastating consequences to adolescent females. With the advent of in vitro fertilization, surgeons should attempt to perform the most conservative surgery that is safely possible, in order to maintain the option of future childbearing. Diagnosis of endometriosis should not be delayed in adolescents. A delay may not only postpone symptomatic relief but also worsen the patient's future fertility and allow the disease to progress. Laparoscopy, as it applies to the pediatric and adolescent population, is a relative newcomer to the field.

  • Chapter 4 - Ectopic Pregnancy

  • from Part I - ANTEPARTUM
    • By Samantha F. Butts, Assistant Professor, Department of Obstetrics and Gynecology Division of Infant and Reproductive Endocrinology University of Pennsylvania Medical School Philadelphia, Pennsylvania, David B. Seifer, Professor, Department of Obstetrics, Gynecology, and Reproductive Sciences Mount Sinai School of Medicine New York
  • John Patrick O'Grady, Tufts University, Massachusetts, Martin L. Gimovsky, Lucy A. Bayer-Zwirello, Kevin Giordano
  • Book:
    Operative Obstetrics
    Published online:
    07 May 2010
    Print publication:
    04 August 2008, pp 69-88

  • Summary

    This chapter provides a comprehensive discussion of the contemporary approach to ectopic pregnancy. It reviews the diagnosis and treatment options and the epidemiology and pathophysiology of ectopic pregnancy. Abnormalities of tubal function and ovum quality or an altered hormonal milieu may each contribute to the development of an ectopic pregnancy. Some of the most significant risk factors for the development of ectopic pregnancy include history of pelvic inflammatory disease (PID), prior fallopian tube surgery, increasing age, and a history of infertility. Prior tubal surgery results in an increased risk of ectopic implantation. Although surgery remains the mainstay of treatment for ectopic pregnancy, medical management is a widely used alternative. Methotrexate therapy for ectopic pregnancy is a widely used medical alternative to surgery. The use of proteomics to aid in the detection of early ectopic pregnancy is an active area of research.