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Acta Cir Bras 2019 Feb 14;34(1):e20190010000010. Epub 2019 Feb 14.

Associate Professor III, Department of Gynecology and Obstetrics, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Conception and design of the study, manuscript preparation.

Purpose: To evaluate agreement between pre- and post-laparoscopy gynecological diagnosis in order to demonstrate the rationality of this minimally invasive technique use in gynecological propaedeutics.

Methods: Retrospective chart review study conducted between March 2010 and October 2016 based on a convenience sample. 315 patients undergoing surgical laparoscopy at the Center of Gynecologic Endoscopy and Family Planning of Botucatu Medical School/UNESP. Read More

Int J Colorectal Dis 2019 Feb 19. Epub 2019 Feb 19.

Department of Emergency and Organ Transplantation and Inter-Department Research Center for Pelvic Floor Diseases (CIRPAP), University "Aldo Moro" of Bari, Piazza G Cesare, 11, 70124, Bari, Italy.

Aim: To evaluate the reason for failure of STARR (stapled transanal rectal resection) operation for obstructed defecation.

Methods: A retrospective study (June 2012-December 2017) was performed using a prospectively maintained database of patients who underwent STARR operation for ODS (obstructed defecation syndrome), complaining of persisting or de novo occurrence of pelvic floor dysfunctions. Postoperative St Mark's and ODS scores were evaluated. Read More

BMJ Open 2019 Feb 19;9(2):e025436. Epub 2019 Feb 19.

School of Nursing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Introduction: A growing body of evidence is identifying the link between a history of child maltreatment and a variety of adverse health outcomes ultimately leading to significant social and healthcare burden. Initial work has identified a potential association between child maltreatment and the development of a selection of somatic and visceral central sensitivity syndromes: fibromyalgia, chronic fatigue syndrome, temporomandibular joint disorder, chronic lower back pain, chronic neck pain, chronic pelvic pain, interstitial cystitis, vulvodynia, chronic prostatitis, tension-type headache, migraine, myofascial pain syndrome, irritable bowel syndrome and restless legs syndrome.

Methods And Analysis: Primary electronic searches will be performed in the Embase, MEDLINE, PubMed, Scopus, PyscINFO, CINAHL and Cochrane Library databases and a number of Grey Literature sources including child protection and paediatric conference proceedings. Read More

BMJ Open 2019 Jan 9;9(1):e019570. Epub 2019 Jan 9.

Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland.

Objectives: Endometriosis is a gynaecological disease most commonly causing severe and chronic pelvic pain as well as an impaired quality of life. The aim of this study was to investigate if and how endometriosis affects choices regarding professional life as well as the quality of daily working life.

Design, Setting And Participants: In the context of a multicentre case-control study, we collected data from 505 women with surgically/histologically confirmed diagnosis of endometriosis and 505 matched controls. Read More

J Am Vet Med Assoc 2019 Mar;254(5):613-618

CASE DESCRIPTION A 12-year-old obese spayed female American Staffordshire Terrier was admitted for evaluation of acute non-weight-bearing lameness of the right pelvic limb attributed to motor vehicle-related trauma that occurred 2 hours previously. The owners reported a chronic, progressive weight-bearing lameness of the right pelvic limb secondary to a complete cranial cruciate ligament (CrCL) rupture that was diagnosed 6 months previously. They had declined surgery for CrCL repair because of the advanced age of the dog. Read More

Climacteric 2019 Feb 18:1-7. Epub 2019 Feb 18.

a Department of Obstetrics and Gynaecology, Helsinki University Hospital , Helsinki University , Helsinki , Finland.

Stress urinary incontinence (SUI) affects millions of women worldwide. Pelvic floor muscle training is the first-line treatment for SUI, and if this fails, midurethral sling surgery has become the gold-standard treatment. More recently, complications from midurethral mesh slings, particularly chronic pain and dyspareunia, have become a major concern. Read More

Aktuelle Urol 2019 Feb 14. Epub 2019 Feb 14.

Ambulantes Rehabilitations-Zentrum für Urologie und Gynäkologie Heidelberg, Facharztpraxis für Urologie, Heidelberg.

In specialist urology clinics, 50 - 70 % of patients have chronic urological diseases such as recurrent urinary tract infections, a somatoform overactive bladder, adult and infantile enuresis, a chronic pelvic pain syndrome, and the psychosomatic form of post-prostatectomy incontinence. The 12-month prevalence of psychological disorders in the general adult population is 28 % 1. As many as 20 % of children and adolescents are found to have psychological abnormalities 2. Read More

J Urol 2019 Feb 7. Epub 2019 Feb 7.

Urologiia 2018 Dec(6):101-106

Department of Polyclinic Therapy and Medical Rehabilitation with the course of Additional Professional Education Federal State Educational Institution of Higher Education Altai State Medical University of the Ministry of Health of the Russian Federation, Barnaul, Russia.

The aim of the study was to increase the efficiency of complex treatment of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with the combined effect of magnetolaser therapy (MLT) and red light.

Materials And Methods: We examined and included in the study 120 men with a verified diagnosis of CP/CPPS (III B), at the stage of exacerbation. By envelope method, patients were divided into two randomized groups. Read More

PM R 2019 Feb 6. Epub 2019 Feb 6.

Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO.

Background: Female chronic pelvic pain is estimated to affect up to 24% of adult women, many of whom have a component of myofascial pelvic pain. Although an association of joint hypermobility and pelvic pain has been hypothesized, limited data are available that estimate the prevalence of joint hypermobility in this population.

Objective: To estimate the prevalence of generalized hypermobility spectrum disorder (G-HSD) among female patients with chronic myofascial pelvic pain and examine the association between G-HSD and other frequent pelvic pain-associated complaints. Read More

Minerva Ginecol 2019 Feb 6. Epub 2019 Feb 6.

Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.

Sexual dysfunctions, particularly sexual pain, are common in adult women of all ages. In patients with endometriosis, a chronic gynaecological pain condition affecting women of reproductive age, sexual pain is the third most common symptom. Multiple biological factors are involved in endometriosis-related sexual pain including tissue damage, inflammation, hormonal changes, alterations within the peripheral and central nervous system and pelvic floor muscle dysfunctions. Read More

Biol Reprod 2019 Feb 4. Epub 2019 Feb 4.

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06520, USA.

MicroRNAs (miRNAs), a class of small non-coding RNA molecules, have been recognized as key post-transcriptional regulators associated with a multitude of human diseases. Global expression profiling studies have uncovered hundreds of miRNAs that are dysregulated in several diseases, and yielded many candidate biomarkers. This review will focus on miRNAs in endometriosis, a common chronic disease affecting nearly 10% of reproductive-aged women, which can cause pelvic pain, infertility, and a myriad of other symptoms. Read More

Inflammation 2019 Feb 4. Epub 2019 Feb 4.

Department of Clinical Pharmacy, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 211198, Jiangsu Province, China.

The exact etiology and pathogenesis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are still unknown, as a result, available therapeutic options for patients are far from satisfactory. Therefore, there is a need to develop a valid therapeutic approach that can ameliorate the manifestations of CP/CPPS. Fifty male C57BL/6 mice were randomly divided into five groups of ten mice each. Read More

Musculoskelet Sci Pract 2019 Jan 28;40:58-64. Epub 2019 Jan 28.

234 Maeji-ri, Heungeop-Myeon, Wonju, Kangwon-Do, 220-710, Department of Physical Therapy, Graduate School, Yonsei University, Wonju, South Korea. Electronic address:

Background: Because patients with nonspecific chronic low back pain (NSCLBP) are heterogeneous, subgrouping patients with NSCLBP might clarify the research findings. NSCLBP in the direction of extension movement, namely active extension pattern (AEP), is common during prolonged standing.

Objective: Predictors of pain intensity and dysfunction were determined in prolonged standing service workers (PSSWs) with NSCLBP subclassified as AEP in the motor impairment subgroup. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Mar 22;234:171-178. Epub 2019 Jan 22.

Acute Gynaecology, Early Pregnancy and Advanced Endosurgery Unit, Sydney Medical School Nepean, University of Sydney, Nepean Hospital, Penrith, NSW, Australia; OMNI Gynaecological Care Centre for Women's Ultrasound and Early Pregnancy, St Leonards, NSW, Australia.

Objective: Evaluate whether symptoms and/or transvaginal ultrasound (TVS) 'soft markers' (ovarian immobility and/or site-specific tenderness (SST)) are associated with endometriosis type/location.

Study Design: Multicenter prospective observational study (January 2009 to February 2013) in tertiary centers for women with chronic pelvic pain who underwent detailed history, specialized TVS, and laparoscopy. Chart findings were collated into a study database. Read More

J Pediatr Adolesc Gynecol 2019 Jan 29. Epub 2019 Jan 29.

Division of Gynecology, Department of Surgery, Boston Children's Hospital; Division of Minimally Invasive Surgery, Brigham & Women's Hospital; Boston Center for Endometriosis; Harvard Medical School, Boston, Massachusetts.

Background: Adolescent endometriosis typically presents as Stage I with superficial peritoneal disease [SPD] and less commonly as Stage III or IV with deeply infiltrative disease [DIE]. Endometriosis lesions can be destroyed (cautery or laser), cutting out the discrete lesion with excision and destroyed, or radically excised with removal of the lesion and surrounding tissue. It has been shown to be beneficial to excise DIE to improve pain. Read More

J Med Chem 2019 Feb 22. Epub 2019 Feb 22.

Bayer AG, Research & Development, Pharmaceuticals , Müllerstrasse 178 , 13353 Berlin , Germany.

The presence and growth of endometrial tissue outside the uterine cavity in endometriosis patients are primarily driven by hormone-dependent and inflammatory processes-the latter being frequently associated with severe, acute, and chronic pelvic pain. The EP4 subtype of prostaglandin E2 (PGE2) receptors (EP4-R) is a particularly promising anti-inflammatory and antinociceptive target as both this receptor subtype and the pathways forming PGE2 are highly expressed in endometriotic lesions. High-throughput screening resulted in the identification of benzimidazole derivatives as novel hEP4-R antagonists. Read More

Scand J Pain 2019 Jan 31. Epub 2019 Jan 31.

Institute of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway.

Background and aims Chronic pelvic pain (CPP) in women is a complex condition that can seriously impact health and quality of life. Clinical guidelines for CPP place great demands on healthcare professionals, as they require both specialized knowledge about the pelvic area and knowledge of the mechanisms of chronic pain. To ensure best possible assessment and treatment of these women it is important to bring about more knowledge of the special CPP features. Read More

Minerva Ginecol 2019 Jan 28. Epub 2019 Jan 28.

3 Unit of Gynecology and Human Reproduction Physiopathology, Department of Obstetrics and Gynecology, S. Orsola Hospital, University of Bologna, Bologna, Italy.

Dysmenorrhea and chronic pelvic pain occur in a significantly higher percentage in women with endometriosis; this benign condition has an incidence ranging from 5 to 10% in the general population, while 35% to 50% of infertile women are affected. Treatment of the symptoms demands integrated approaches with the use of anti-inflammatory substances or drugs and lifestyle changes, including attention to diet. The use of traditional anti-inflammatory drugs over the long term is not very successful because of the fear of side effects so they are almost always used with a short-term formula of 7-10 days when the woman's general condition becomes difficult to bear. Read More

Phys Ther 2019 Mar;99(3):297-310

Institute of Sport, Physical Education and Health Sciences, University of Edinburgh; and Institute for Clinical Exercise and Health Science, University of the West of Scotland, Hamilton, United Kingdom.

Background: Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physical therapists for CLBP treatment and management; however, there are no data on trunk muscle activation during aquatic exercises in people with CLBP.

Objective: We quantified activation of trunk and gluteal muscles, exercise intensity, pain, and perceived exertion in people with and without CLBP when performing water and land exercises. Read More

Front Syst Neurosci 2018 11;12:69. Epub 2019 Jan 11.

Division of Urology, Department of Surgery, School of Medicine, University of Colorado Denver, Aurora, CO, United States.

Early activation of transcription factors is one of the epigenetic mechanisms contributing to the induction and maintenance of chronic pain states. Previous studies identified the changes in a number of nociception-related genes, such as calcitonin gene-related peptide (CGRP), substance P (SP), and brain-derived neurotropic factor (BDNF) in the pelvic organs after transient colonic inflammation. The gene and protein expression of these neuropeptides could be modulated by transcription factors Methyl-CpG-binding protein 2 (Mecp2) and cAMP response element-binding protein (CREB). Read More

Urology 2019 Jan 22. Epub 2019 Jan 22.

Department of Neurology, Medical College of Wisconsin, Milwaukee, WI. Electronic address:

Objective: To evaluate whether voiding parameters differ in patients with the common overlapping pelvic pain disorders, interstitial cystitis/bladder pain syndrome (IC/BPS), and myofascial pelvic pain (MPP).

Methods: Uroflow and voiding diary assessed voiding phenotypes in this prospective cohort study (ICEPAC) of women comparing IC/BPS, IC/BPS +MPP, MPP, and healthy control (HC) subjects.

Results: In 36 HC, 24 IC/BPS, 37 IC/BPS + MPP, and 14 MPP subjects, the voiding diary measurements indicate lower voided volumes in IC/BPS and IC/BPS + MPP groups (185 ± 24 mL, 169 ± 20 mL, respectively) compared to HC and MPP groups (294 ± 24 mL, 226 ± 36 mL, respectively; P <. Read More

Cochrane Database Syst Rev 2019 Jan 25;1:CD010871. Epub 2019 Jan 25.

Clinical Research Institute, Faculty of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.

Background: The genital infection caused by Chlamydia trachomatis (CT) is a common sexually transmitted infection (STI) globally. The infection is mainly asymptomatic in women, thus it can produce infertility and chronic pelvic pain. In men infection is mainly symptomatic, but can evolve to prostatitis. Read More

Neurourol Urodyn 2019 Jan 25. Epub 2019 Jan 25.

Department of Urology, Universite de Ouagadougou, Centre Region, Burkina Faso.

Female genital mutilation/cutting (FGM/C)-also known as Female Genital Cutting or Mutilation-is defined as the partial or total removal of the female external genitalia for non-therapeutic reasons. This White Paper, prepared under the auspices of the International Continence Society (ICS), is intended by the ICS as a statement promoting the abandonment of this practice. The ICS also supports the respectful and evidence-based care or treatment of women and girls already affected by FGM/C, in keeping with the World Health Organization (WHO) Guidelines on the Management of Health Complications from Female Genital Mutilation. Read More

HSOA J Reprod Med Gynaecol Obstet 2017 Dec 30;2. Epub 2017 Dec 30.

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

Background: Aberrant progesterone signaling has been demonstrated in mechanistic studies to be a shared common pathway in fibroids and endometriosis. Progesterone receptor modulation with the selective progesterone receptor modulator (SPRM) ulipristal may decrease pain associated with endometriosis.

Case: A 25-year-old nulligravidae with endometriosis-related pelvic pain refractory to medical and surgical intervention was administered 15mg ulipristal every other day for 3 months. Read More

Cent European J Urol 2018 27;71(4):448-452. Epub 2018 Dec 27.

FA für Gynäkologie, Geburtshilfe und Chirurgie, Akademisches Lehrkrankenhaus, Feldkirch, Austria.

Introduction: Current thinking is that chronic pelvic pain of unknown origin (CPPU) is poorly understood and its treatment is empirical and ineffective. According to the Integral Theory System (ITS), however, CPPU is secondary to uterosacral ligament (USL) laxity which is associated with bladder and bowel symptoms and all are potentially curable by surgical reinforcement of USLs.

Material And Methods: We applied the ITS to anatomically explain the pathogenesis and cure of these conditions. Read More

Cent European J Urol 2018 9;71(4):444-447. Epub 2019 Nov 9.

Department of Gynecology, Kamakura Hospital, Kamakura, Japan.

Introduction: The aim of this study was to compare the posterior fornix syndrome (PFS), (abnormal bladder emptying, urge, frequency, nocturia, chronic pelvic pain) cured/improved by uterosacral ligament (USL) ligation, with 'underactive bladder' (UAB) [2], whose cause and cure of UAB are said to be unknown [2].

Material And Methods: A limited literature search was carried out for the words posterior fornix syndrome; obstructed micturition; post-void residual.

Results: We found the diagnostic criteria used for UAB to be identical with PFS. Read More

Cent European J Urol 2018 19;71(4):436-443. Epub 2018 Oct 19.

Institute of Molecular Medicine, University of Lisbon, Portugal.

Introduction: The aim of this study was to independently evaluate idiopathic urinary retention and other known Fowler's syndrome (FS) descriptions in 24 women treated for posterior fornix syndrome (PFS) by reinforcement of the uterosacral ligaments (USL) using the tissue fixation system (TFS).

Material And Methods: The main inclusion criterion was: idiopathic urinary retention with post-void residual urines (PVR) >100 ml.

Results: The mean patient age was 63 years (range 32-87). Read More

J Urol 2019 Jan 29. Epub 2019 Jan 29.

Department of Urology, University of California-Irvine, Irvine, California.

Purpose: The opioid problem has reached epidemic proportions and the prescription of opioids after surgery can lead to chronic use. We explored prescribing patterns and opioid use after 3 pelvic floor surgeries (sacral neuromodulation, prolapse repair and mid urethral sling) before and after an educational intervention to reduce opioid prescriptions.

Materials And Methods: We retrospectively reviewed the amount of opioid medication prescribed to patients who underwent these 3 types of surgeries at our institution from June 2016 to May 2017. Read More

Colorectal Dis 2019 Jan 23. Epub 2019 Jan 23.

Royal Liverpool and Broadgreen University Hospital NHS Trust, Liverpool, United Kingdom.

Trans anal endoscopic microsurgery (TEMS) is a recognized technique for treating benign rectal polyps and early rectal cancer. We report that TEMS is a treatment option for rectal endometriosis [1,2]. A 35 year old otherwise healthy nulliparous lady presented with cyclical dyschezia, chronic pelvic pain, severe dysmenorrhea and rectal bleeding. Read More

Br J Pain 2019 Feb 15;13(1):54-58. Epub 2018 May 15.

Department of Orthopaedics and Traumatology, University Hospital of Siena, Siena, Italy.

Context: Vulvodynia is defined as a chronic vulvar pain non-associated with infectious, inflammatory, neoplastic or hormonal disorders.

Objectives: To present a case demonstrating the difficulty in assessing concomitant disease in vulvodynia.

Methods: A 26-year-old woman, presented with persistent vulvodynia. Read More

Reprod Sci 2019 Jan 22:1933719118820469. Epub 2019 Jan 22.

1 Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Background:: This study aimed to investigate potential factors, especially early-life exposures, associated with endometrioma (OMA) and/or deep infiltrating endometriosis (DIE) in Chinese women.

Methods:: This is a subgroup analyses of the FEELING study, which was a case-control study that investigated the clinical, lifestyle, and environmental factors associated with OMA and/or DIE in China, Russia, and France. In this subgroup analysis, the data for the Chinese participants were further analyzed using logistic regression model. Read More

BMC Musculoskelet Disord 2019 Jan 18;20(1):28. Epub 2019 Jan 18.

School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.

Background: Interventions for low back pain (LBP) commonly target 'dysfunctional' or atypical lumbo-pelvic kinematics in the belief that correcting aberrant movement improves patients' pain and activity outcomes. If atypical kinematic parameters and postures have a relationship to LBP, they could be expected to more prevalent in people with LBP compared to people without LBP (NoLBP). This exploratory study measured, defined and compared atypical kinematic parameters in people with and without LBP. Read More

Pain Med 2019 Jan 17. Epub 2019 Jan 17.

Consultant Pain Medicine, Walton Centre of Neurosciences, UK.

Arch Ital Urol Androl 2019 Jan 18;90(4):260-264. Epub 2019 Jan 18.

Department of Gynaecological and Urological Sciences, Sapienza University of Rome.

Introduction: Chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS) represents a challenge for the urologist, since the therapeutic efficacy does not always result in a satisfactory quality of life for the patients. Often the side effects of the medications used (antiinflammatories, antibiotics, alpha blockers) far outweighs the benefits gained with their admission. The choice of nutraceutical medications is preferred for their effectiveness, that has been accepted and proven by the scientific community, and for the low incidence of side effects. Read More

Arch Ital Urol Androl 2019 Jan 18;90(4):227-248. Epub 2019 Jan 18.

ASST Nord Milano.

The modern clinical research on prostatitis started with the work of Stamey and coworkers who developed the basic principles we are still using. They established the segmented culture technique for localizing the infections in the males to the urethra, the bladder, or the prostate and to differentiate the main categories of prostatitis. Such categories with slight modifications are still used according to the NIH classification: acute bacterial prostatitis, chronic bacterial prostatitis, Chronic Pelvic Pain Syndrome (CPPS) and asymptomatic prostatitis. Read More

CVIR Endovasc 2018 30;1(1):16. Epub 2018 Aug 30.

1Department of Radiology, Vascular and Interventional Radiology Section, NYU Langone Medical Center, 550 1st Avenue, 2nd Floor, New York, NY 10016 USA.

Background: Chronic venous occlusion is common particularly in cancer patient due to hypercoagulate state associated with venous compression. Treatment options include endovascular management with venoplasty and stenting. Recanalization can be challenging in patients with complete venous occlusion secondary to significant external compression by a mass. Read More

J Neurogastroenterol Motil 2019 Jan;25(1):129-136

Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, USA.

Background/aims: Although symptoms related to the pelvic floor, such as pelvic organ prolapse (POP) and lower urinary tract symptoms (LUTS), are common in patients with chronic constipation (CC), its impact is not clear. Our aims were to investigate the following (1) compare pelvic floor symptom related dysfunction in irritable bowel syndrome with constipation (IBS-C) and functional constipation (FC), and (2) symptom correlation with findings on anorectal manometry (ARM) and balloon expulsion test.

Methods: This was a retrospective analysis of patients with CC undergoing ARM. Read More

Postgrad Med J 2019 Jan 12. Epub 2019 Jan 12.

Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, Heliodor Swiecicki Clinical Hospital, Poznan University of Medical Sciences, Poznań, Poland.

According to the current recommendations on the management of chronic non-specific low back pain (CNLBP), the intervention in this group of patients should include a programme of exercises. Pilates is a system of exercises widely used in patients with low back pain. The practices based on this method have promoted the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. Read More

Female Pelvic Med Reconstr Surg 2019 Jan 8. Epub 2019 Jan 8.

Department of Obstetrics and Gynecology, Michigan Medicine, Ann Arbor, MI.

Objectives: This study aimed to characterize the prevalence of lower urinary tract symptoms in a chronic pain population.

Methods: In this observational cohort study, patients referred to a female pelvic pain clinic completed several validated questionnaires assessing bladder symptoms, central sensitization, pain symptoms, depression, anxiety, and neuropathic pain. Patients diagnosed as having interstitial cystitis were excluded. Read More

Sci Transl Med 2019 Jan;11(474)

Department of Obstetrics, Gynecology and Reproductive Biology, Michigan State University, Grand Rapids, MI 49534, USA.

Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside the uterus and causes chronic pelvic pain and infertility. However, the exact mechanisms of the pathogenesis of endometriosis-associated infertility are unknown. Epigenetic dysregulation has recently been implicated in infertility. Read More

Am J Obstet Gynecol 2019 Jan 6. Epub 2019 Jan 6.

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT. Electronic address:

Endometriosis can have a profound impact on women's lives, including associated pain, infertility, decreased quality of life, and interference with daily life, relationships, and livelihood. The first step in alleviating these adverse sequelae is to diagnose the underlying condition. For many women, the journey to endometriosis diagnosis is long and fraught with barriers and misdiagnoses. Read More

PLoS One 2019 9;14(1):e0207422. Epub 2019 Jan 9.

Department of Microbiology and Immunology, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.

Problem: Chlamydia trachomatis infections are often associated with acute syndromes including cervicitis, urethritis, and endometritis, which can lead to chronic sequelae such as pelvic inflammatory disease (PID), chronic pelvic pain, ectopic pregnancy, and tubal infertility. As epithelial cells are the primary cell type productively infected during genital tract Chlamydia infections, we investigated whether Chlamydia has any impact on the integrity of the host epithelial barrier as a possible mechanism to facilitate the dissemination of infection, and examined whether TLR3 function modulates its impact.

Method Of Study: We used wild-type and TLR3-deficient murine oviduct epithelial (OE) cells to ascertain whether C. Read More

Phlebology 2019 Jan 8:268355518821554. Epub 2019 Jan 8.

Academic Surgery Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.

Objectives: This modified Delphi study of vascular interventional radiologists sought to achieve consensus statements on the optimal imaging strategy and definitions of important imaging diagnostic features in women with pelvic vein incompetence.

Method: The UK-based interventional radiologists with the experience of investigating and treating pelvic vein incompetence responded to up to three rounds of online questionnaires.

Results: Three consensus statements emerged from 27 responders: (1) catheter venography is the 'gold standard' investigation for the diagnosis of pelvic vein incompetence; (2) pelvic vein incompetence should be defined as 'retrograde flow along the ovarian or internal iliac veins'; (3) pelvic varices should be defined as 'tortuous, often dilated, vulval, adnexal, para-uterine veins arising from incompetent internal iliac or ovarian veins. Read More

Int Urogynecol J 2019 Jan 7. Epub 2019 Jan 7.

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Building 31; Room B2 B32, 9000 Rockville Pike, Bethesda, MD, USA.

Introduction And Hypothesis: Botulinum toxin (BoNT) is increasingly used for pain, especially with muscle spasm. We describe our methodology for BoNT treatment of chronic pelvic pain (CPP) in women and place it in the context of the literature on techniques for this use.

Methods: Databases were searched using terms "botulinum toxin," "pelvic pain," and "vaginismus. Read More

Orthop Traumatol Surg Res 2019 Feb 4;105(1S):S31-S42. Epub 2019 Jan 4.

Orthopaedics Department, Angelholm Hospital, Sweden.

The sacro-iliac joint (SIJ) located at the transition between the spine and the lower limbs is subjected to major shear forces. Mobility at the SIJ is very limited but increases during pregnancy and the post-partum period. Familiarity with the anatomy and physiology of the SIJ is important. Read More

Gynecol Endocrinol 2019 Jan 6:1-4. Epub 2019 Jan 6.

a Obstetrics and Gynecology Unit , University Hospital of Modena , Modena , Italy.

Women with chronic pelvic pain (CPP) frequently suffer from mood disturbances and reduced quality of life. Whether pain improvement ameliorates mood and quality of life is still unclear, and it was investigated in an observational prospective study performed in a cohort of 117 of the outpatient services for endometriosis and chronic pelvic pain at a University Hospital. Depending on disease, women were treated either by surgery or by the administration of an estrogen-progestin or a progestin alone. Read More

Neurourol Urodyn 2018 Aug;37(S6):S32-S38

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, Pennsylvania.

Aims: Chronic pelvic pain (CPP) is defined as a noncyclical pain that has duration of at least 6 months and can lead to decreased quality of life and physical performance. The pain can be attributed to problems in the pelvic organs and/or problems in related systems, and possible psycho-social attributes may contribute to the manifestation. Due to the complex nature, CPP syndromes are multifactorial and the terminology needs to reflect the setting. Read More

Open Access J Sports Med 2019 24;10:1-10. Epub 2018 Dec 24.

Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy.

Osteitis pubis is a common cause of chronic groin pain, especially in athletes. Although a precise etiology is not defined, it seems to be related to muscular imbalance and pelvic instability. Diagnosis is based on detailed history, clinical evaluation, and imaging, which are crucial for a correct diagnosis and proper management. Read More

Trauma Violence Abuse 2019 Jan 1:1524838018821950. Epub 2019 Jan 1.

1 Steve Hicks School of Social Work, University of Texas at Austin, Austin, TX, USA.

Chronic pelvic pain (CPP) is a widespread health issue with unclear etiology that has been linked to a history of trauma among women. This condition is known to be highly comorbid with, and potentially exacerbated by psychiatric conditions, as well as other gynecological concerns and functional pain syndromes. Many comorbid conditions are also related to a history of trauma, and cases of CPP with comorbidity are known to be resistant to treatment. Read More