4: Which Cause of Pelvic Pain? Flashcards Preview

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Flashcards in 4: Which Cause of Pelvic Pain? Deck (12)
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1
Q

Which cause of pelvic pain? Signs include:

  • May elicit abdominal pain with light palpation
  • Decreased motility of pelvic organs
  • Adnexal enlargement
A

Adhesions

2
Q

Which cause of pelvic pain? Diagnosis includes:

Laparoscopy is the diagnostic tool of choice if somatic causes are ruled out and the psychosocial evaluation is negative

A

Adhesions

3
Q

Which non-cyclic cause of pelvic pain? Diagnosis includes:

  • US
  • Note: US may be improved by treating the woman with clomiphene citrate (Clomid) 100 mg for 5–10 days prior to the US to stimulate follicular development
A

Ovarian remnant/retention syndrome

4
Q

Which non-cyclic cause of pelvic pain? Management:

  • Initial treatment with danazol or high-dose progestins may be helpful in some cases
  • GnRH agonist may help but cannot be used for long-term therapy
  • Surgical excision is often required
A

Ovarian remnant/retention syndrome

5
Q

Which non-cyclic cause of pelvic pain? Signs include:

  • Bulky feeling to uterus when palpated during the bimanual examination
  • Ovaries may be enlarged and there may be many functional cysts on the ovaries
  • Uterus, parametria, and uterosacral ligaments are tender to touch
A

Pelvic congestion syndrome

6
Q

Which non-cyclic cause of pelvic pain? Symptoms include:

  • Bilateral lower abdominal and back pain
  • Dysmenorrhea
  • Dyspareunia
  • Abnormal uterine bleeding
  • Chronic fatigue
  • Irritable bowel syndrome
A

Pelvic congestion syndrome

7
Q

Which cause of pelvic pain? Symptoms include:

  • Lateral pelvic pain described as sharp and stabbing or dull and not radiating
  • May have dyspareunia, constipation, or flank pain
  • May have genitourinary and/or gastrointestinal symptoms that accompany the pelvic pain
A

Ovarian remnant/retention syndrome

8
Q

Which non-cyclic cause of pelvic pain? Diagnosis includes:

  • Transuterine venography is the primary method used for diagnosis
  • Other methods include the following:
    • Ultrasound
    • Magnetic resonance imaging
    • Laparoscopy
A

Pelvic congestion syndrome

9
Q

Which cause of pelvic pain? Symptoms include:

  • Lower abdominal or pelvic pain that occurs or increases when the peritoneum or organ serosa is stretched
  • Dyspareunia
A

Adhesions

10
Q

Which cause of pelvic pain? Signs include:

  • Pelvic mass identified during bimanual examination
  • May observe that the vulva and vagina remain in a persistent estrogenized state
A

Ovarian remnant/retention syndrome

11
Q

Which non-cyclic cause of pelvic pain? Management:

  • Begin with the least invasive measures
  • Hormonal measures include progestin or GnRH agonist administration
  • Ovarian vein embolization or ligation
  • Hysterectomy with bilateral salpingo-oophorectomy should be the last resort
A

Pelvic congestion syndrome

12
Q

Which cause of pelvic pain? Management includes:

Surgical lysis of adhesions only after a thorough evaluation and failed medical therapy

A

Adhesions

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