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Title: Serious morbidity with long-term IUD retention [letter]
Author: Pillai M; Van de Venne M; Shefras J
Source: Journal of Family Planning and Reproductive Health Care. 2009 Apr;35(2):131-2; author reply 132.
Abstract: This letter to the editor examines serious health problems resulting from long-term IUD retention in women experiencing menopause and in the years following. It recommends that current guidelines be revised to include some emphasis on the importance of timely removal of an IUD once its contraceptive properties are no longer required for the IUD user.
Language: English
Keywords:
UNITED KINGDOM | SUMMARY REPORT | CASE HISTORIES | CLIENTS | IUD, COPPER RELEASING | IUD COMPLICATIONS | TIME FACTORS | PELVIC INFECTIONS | Developed Countries | Europe, Western | Europe | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Population Dynamics | Demographic Factors | Population | Infections | Diseases
Document Number: 341648

Peer Reviewed

Title: Implanon versus medroxyprogesterone acetate: effects on pain scores in patients with symptomatic endometriosis--a pilot study.
Author: Walch K; Unfried G; Huber J; Kurz C; van Trotsenburg M; Pernicka E; Wenzl R
Source: Contraception. 2009 Jan;79(1):29-34.
Abstract: BACKGROUND: Implanon has been reported to be effective in the treatment of dysmenorrhea. We compared the therapeutic efficacies of depot medroxyprogesterone acetate (DMPA) and Implanon with regard to pain relief in women with endometriosis. STUDY DESIGN: In a clinical research center at a university hospital, 41 patients with dysmenorrhea, nonmenstrual pelvic pain and dyspareunia associated with histologically proven endometriosis were included in an open, prospective, randomized, controlled clinical trial. Twenty-one women were assigned by computer-generated randomization to receive Implanon, and 20 women to receive DMPA. As main outcome measures of this pilot study, we evaluated pain improvement quantified according to visual analog scale score, side effects, vaginal bleeding patterns, withdrawal rate and overall degree of satisfaction. RESULTS: During a follow-up period of 1 year, we ascertained a clear improvement in pain intensity for both treatment options. After 6 months, the average decrease in pain was 68% in the Implanon group and 53% in the DMPA group. The side-effects profile and the overall degree of satisfaction after study termination were comparable for both treatment options. CONCLUSION: Concerning pain relief, the therapeutic efficacy of the contraceptive implant Implanon is not inferior to that of DMPA in symptomatic endometriosis.
Language: English
Keywords:
AUSTRIA | NETHERLANDS | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | ENDOMETRIOSIS | PAIN | PELVIC INFECTIONS | CONTRACEPTIVE AGENTS, PROGESTIN | MEDROXYPROGESTERONE ACETATE | TREATMENT | Developed Countries | Europe, Central | Europe | Europe, Western | Research Methodology | Demographic Factors | Population | Diseases | Signs and Symptoms | Infections | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 330538

3.
Title: Mid-level health-care providers are a safe alternative to doctors for first-trimester abortions in developing countries.
Author: World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction; World Health Organization [WHO]. Department of Reproductive Health and Research
Source: Geneva, Switzerland, WHO, 2008. [2] p. (Social Science Research Policy Briefs)
Abstract: In circumstances where the law permits termination of pregnancy, access to safe induced abortion may still be restricted by limited availability of trained health-care providers. In most countries where abortion is legal, only doctors are authorized to provide first-trimester abortions. To increase access to safe first-trimester abortion and conserve scarce health resources, some countries have trained nurses, midwives and mid-level health-care providers such as doctor assistants. These health-care providers are generally cost-effective and may work in areas where doctors are scarce, providing health services to underserved populations. Before this study, however, no comparative assessment of the safety of first-trimester abortion by type of provider had been conducted in developing countries. (excerpt)
Language: English
Keywords:
VIETNAM | SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | HEALTH PERSONNEL | PREGNANCY, FIRST TRIMESTER | ABORTION | SAFETY | BLEEDING | CERVICAL EFFECTS | PELVIC INFECTIONS | Developing Countries | Asia, Southeastern | Asia | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Delivery of Health Care | Health | Pregnancy | Reproduction | Fertility Control, Postconception | Family Planning | Public Health | Signs and Symptoms | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections
Document Number: 326305 Notification

Title: Gynecologic issues in the HIV-infected woman.
Author: Cejtin HE
Source: Infectious Disease Clinics of North America. 2008 Dec;22(4):709-39, vii.
Abstract: In this article, gynecologic conditions of increased importance in the HIV-infected woman are discussed. Women living with HIV may have an increase in menstrual disorders, lower genital tract neoplasias, gynecologic surgery, and sexually transmitted infections. The literature relevant to choosing a method of contraception for HIV-positive women is also discussed. With the advent of HAART, seropositive women are now facing issues around longevity, such as menopause and disorders of bone mineral density, as well as those associated with fertility.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | MANAGEMENT | WOMEN | VAGINITIS | PELVIC INFECTIONS | SEXUALLY TRANSMITTED DISEASES | EXAMINATIONS AND DIAGNOSES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Organization and Administration | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Infections | Reproductive Tract Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329614

Title: Non-contraceptive benefits of oral contraceptives.
Author: Huber JC; Bentz EK; Ott J; Tempfer CB
Source: Expert Opinion On Pharmacotherapy. 2008 Sep;9(13):2317-25.
Abstract: BACKGROUND: There is increasing awareness of the opportunity that many contraceptive interventions may provide for additional health benefits. However, treatment of medical problems with oral contraceptives (OCs) is often an 'off-label' practice. OBJECTIVE: The aim of this review is to summarize available data on non-contraceptive benefits of OCs. METHODS: Review of the literature. RESULTS: OCs have been shown to reduce the risk of ovarian, endometrial, and colorectal cancer. It has been suggested that OCs may be used in treatment of endometriosis, menorrhagia, and uterine leiomyomas. Pelvic inflammatory disease, dysmenorrhea, premenstrual syndrome, and acne have been shown to improve under OCs. CONCLUSION: OCs are important for global and female health. Besides contraception, non-contraceptive effects of OCs are evidence based, well established, and commonly used in clinical practice.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | ENDOMETRIOSIS | ACNE | ENDOMETRIAL CANCER | MENSTRUATION DISORDERS | OVARIAN CANCER | PELVIC INFECTIONS | PREMENSTRUAL TENSION | ORAL CONTRACEPTIVES | Diseases | Dermatitis | Cancer | Neoplasms | Infections | Contraceptive Methods | Contraception | Family Planning
Document Number: 328808

Peer Reviewed

Title: The effects of TCu-380A on cervicovaginal flora.
Author: Kanat-Pektas M; Ozat M; Gungor T
Source: Archives of Gynecology and Obstetrics. 2008 May;277(5):429-432.
Abstract: This study aims to identify the alterations in cervicovaginal flora after insertion of TCu 380A which is a popular type of copper IUD. Among the women who visited the Department of Family Planning in our hospital during 1 month, 100 subjects who preferred IUDs for contraception and who had no history of local or systemic antibiotic use were considered eligible candidates. Anaerobic colonies, especially Gram-positive cocci and Gram-negative bacilli were isolated at significantly higher rates after the insertion of TCu-380A. Aerobic colonies were isolated relatively less. It can be suggested that copper IUD causes the predominance of anaerobic species in the cervicovaginal flora, which is consistent with the literature. This clinically insignificant condition can be attributed to the copper content or threads of the IUDs. Yet there is no evidence that the prevalance of pelvic infections is influenced by the use of IUDs. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | IUD, COPPER RELEASING | IUD SIDE EFFECTS | VAGINAL ABNORMALITIES | CERVICAL EFFECTS | PELVIC INFECTIONS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | IUD | Contraceptive Methods | Contraception | Family Planning | Diseases | Cervix | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections
Document Number: 326106

9.
Peer Reviewed

Title: [Chronic pelvic pain and combined oral hormonal contraception]
Author: Lukanova M; Popov I
Source: Akusherstvo I Ginekologiia. 2008;47(3):20-9.
Abstract: PURPOSE OF THE STUDY: To determine the frequency of usage of combined oral hormonal contraception/COHC/ and its efficiency in women with chronic pelvic pain/CPP/. MATERIALS AND METHODS: Three-hundred and seventy, consecutively admitted in the Clinic women with CPP, were included in the study. They were divided into 2 groups--group A/n = 80/--women that had used COHC, and group B/n = 290/--women that had not used COHC in order to cope with pain symptomatic. The patients from the both groups were compared according to their socio-demographic, menstrual and reproductive characteristics, type of disease, duration of CPP assessment of pain intensity and McGill pain indices, subjective rating of efficiency of the used COHC by the means of 5-rate scale in diseases, manifested with chronic pain symptomatic/leiomyoma /L/ endometriosis/E, pelvic congestion syndrome/PCS/, adhaesion syndrome/AS, Allen-Masters syndrome and other gynaecologic pathology/OGP/--chronic pelvic inflammatory disease/ CPID/, ovarian cysts /OC/, etc./. RESULTS AND DISCUSSION: Duration of CPP /in months/ was comparatively longer in group A /50,74 +/- 10,33/in comparison wit group B/41,38 +/- 5,97/. No significant difference was found in quantitative pain assessment, but in group A higher values of all pain indices/sensory, affective, total pain rating index/and of evaluative overall pain intensity of total pain experience were set, compared with those of group B. It was ascertained a bigger number of types of used medicines in group A/analgesics, spasmolytics, gestagenes and GnRH-agonists/. Efficiency of COHC was assessed by the patients in the range "good-/basically/very good-excellent", and that was well demonstrated by women with L, E, AS and OGP/CPID, etc./. CONCLUSION: COHC was administered to patients with more heavily demonstrated chronic pelvic pain symptomatic, that required combination of more than two medicines in order to obtain a better therapeutic effect. Diseases, manifesting with CPP like E, L and OGP/CPID, OC, AS, etc/are of great priority in treatment with COHC.
Language: Bulgarian
Keywords:
RESEARCH REPORT | CLINICAL TRIALS | WOMEN | PAIN | ORAL CONTRACEPTIVES | PELVIC INFECTIONS | ENDOMETRIOSIS | PELVIC INFLAMMATORY DISEASE | TREATMENT | DRUGS | Clinical Research | Research Methodology | Demographic Factors | Population | Signs and Symptoms | Diseases | Contraceptive Methods | Contraception | Family Planning | Infections | Reproductive Tract Infections | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 329055

10.

11.

Title: Prevalence of infertility in women in a Southwestern Nigerian community.
Author: Sule JO; Erigbali P; Eruom L
Source: African Journal of Biomedical Research. 2008 May;11(2):225-227.
Abstract: The prevalence and common causes of infertility in women aged between 15 and 55 years was assessed in four hospital centers in Osun State, located in the SouthWestern part of Nigeria. A survey of a consecutive sample of 200 cases of infertility were carried out in four hospital centers with a total of 50 cases of infertility evaluated in each of the centers between 2001 - 2003. The incidence of high infertility in women was established in all the centers; (Obafemi Awolowo University Teaching Hospital, Ile-Ife), 59.4%, (Obafemi Awolowo University Teaching Hospital, Ilesa), 47.7%, (Ladoke Akintola University Teaching Hospital, Oshogbo), 54.8% and (General Hospital, Ikire), 44.2%. 77.5% was recorded for a high rate of secondary Infertility, while Primary Infertility was 22.5%. The commonest causes of infertility in this environment were, the tubal factor, uterine factor, and ovarian factor representing 39.5%, 30% and 13% respectively. The least common cause were cervical factor, Pelvic Infection Disease (PID), and endometriosis which was seen in 3%, 5.5% and 2.5% of the subjects respectively. There was also prevalence of infertility between the ages: 15 - 25 years at the rate of 17%, while 26 - 35 years at the rate of 31.5%. The majority of the cases occurred between the ages of 36 - 45 at the rate of 50.5% and between 46 - 55 years at the rate 1%.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | WOMEN | INFERTILITY | ENDOMETRIOSIS | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Demographic Factors | Population | Reproduction | Diseases | Infections | Reproductive Tract Infections
Document Number: 340136

12.

Title: Does physical intimate partner violence affect sexual health? A systematic review.
Author: Coker AL
Source: Trauma, Violence, and Abuse. 2007 Apr;8(2):149-177.
Abstract: Forty years of published research (1966-2006) addressing physical intimate partner violence (IPV) and sexual health was reviewed (51 manuscripts) and synthesized to determine (a) those sexual health indicators for which sufficient evidence is available to suggest a causal association and (b) gaps in the literature for which additional careful research is needed to establish causality and explain mechanisms for these associations. Sexual health was defined as a continuum of indicators of gynecology and reproductive health. IPV was consistently associated with sexual risk taking, inconsistent condom use, or partner nonmonogamy (23 of 27 studies), having an unplanned pregnancy or induced abortion (13 of 16 studies), having a sexually transmitted infection (17 of 24 studies), and sexual dysfunction (17 of 18 studies). A conceptual model was presented to guide further needed research addressing direct and indirect mechanisms by which physical, sexual, and psychological IPV affects sexual health. (author's)
Language: English
Keywords:
DEVELOPING COUNTRIES | LITERATURE REVIEW | RESEARCH REPORT | VIOLENCE AGAINST WOMEN | DOMESTIC VIOLENCE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | REPRODUCTIVE TRACT INFECTIONS | CERVICAL CANCER | NEOPLASMS | INFERTILITY | PAIN | PELVIC INFECTIONS | HYSTERECTOMY | Crime | Social Problems | Sociocultural Factors | Behavior | Infections | Diseases | Cancer | Reproduction | Signs and Symptoms | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 320820

13.

Peer Reviewed

Title: Sonohysterogram, hysterosalpingography, and pelvic ultrasound for diagnosing endometrial tuberculosis.
Author: Duenas-Garcia OF; Rico-Olvera H; Garcia-Tinajero A
Source: International Journal of Gynecology and Obstetrics. 2007 Dec;99(3):242-256.
Abstract: Pelvic tuberculosis is an important cause of infertility in developing countries. There are reports that the most common site of infection is the fallopian tubes, which are affected in almost 100% of cases, followed by the endometrium, which is affected in 50%; few reports document that the endometrium is the most common site. Hysterosalpingography and pelvic ultrasound remain the initial diagnostic procedures for assessing tubal and peritoneal factors leading to infertility. Saline infusion sonohysterogram has been used to improve the accuracy of ultrasound findings when suboptimal ultrasound visualization occurs. However, there have been no previous reports of its use in endometrial tuberculosis. The purpose of this study was to compare these imaging procedures to ascertain the best method for diagnosis of endometrial tuberculosis. (excerpt)
Language: English
Keywords:
MEXICO | RESEARCH REPORT | WOMEN | ULTRASONICS | EXAMINATIONS AND DIAGNOSES | PELVIC INFECTIONS | ENDOMETRIAL EFFECTS | TUBERCULOSIS | North America | Americas | Developing Countries | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Infections | Diseases | Endometrium | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology
Document Number: 322134

14.

Title: Laparoscopic-assisted vaginal hysterectomy for patients with extensive pelvic adhesions: A strategy to minimise conversion to laparotomy.
Author: Hsu WC; Chang WC; Huang SC; Sheu BC; Torng PL
Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2007 Jun;47(3):230-234.
Abstract: The aim was to evaluate a strategy for successful laparoscopic-assisted vaginal hysterectomy (LAVH) in patients with extensive pelvic adhesion. Two hundred and thirty-six patients who underwent LAVH at National Taiwan University Hospital were retrospectively enrolled. Twenty-three patients (9.7%) had unexpected extensive pelvic adhesions. A special procedure of uterine artery preligation through retroperitoneal downstream ureter tracking was applied to overcome this problem. The clinical characteristics of the study group were analysed. The operative parameters and the outcome were compared between those with and without extensive pelvic adhesions. Having extensive adhesions, 17 patients were associated with endometriosis and the other six were secondary to previous Caesarean delivery or pelvic inflammation. The cul-de-sac was partially and totally obliterated in 10 and 13 patients, respectively. These 23 patients had longer operation time (184 vs 146 min, P less than 0.05), more blood loss (146 vs 89 mL, P less than 0.05), but smaller extirpated uteri (278 vs 372 g, P = 0.063), compared with the other 213 patients. The average hospital stay was comparable (3.2 vs 3.4 days) and there were no ureteral injuries or excessive bleeding. Most importantly, not a single case was converted to laparotomy. Pelvic adhesions of various underlying diseases are associated with increased complication and conversion rates during LAVH. Although this technique is not new, we believe that the special procedure of uterine artery preligation through retroperitoneal downstream ureter tracking may provide a safe approach for general gynecologists to complete successful LAVH in patients with unexpected extensive pelvic adhesions. (author's)
Language: English
Keywords:
TAIWAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | PELVIC INFECTIONS | UTERINE EFFECTS | HYSTERECTOMY | PREGNANCY COMPLICATIONS | Asia, Eastern | Asia | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Infections | Diseases | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Gynecologic Surgery | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 313590

15.

Title: Intrauterine contraception: An under-utilized method of family planning [editorial]
Author: Mishell Dr Jr
Source: European Journal of Contraception and Reproductive Health Care. 2007 Mar;12(1):1-2.
Abstract: Women wish their method of contraception to have the following characteristics: a high efficacy; an absence of health risks (especially neoplasia), adverse symptoms, and metabolic effects; a long duration of action; rapid reversibility; cost effectiveness; easily accessibility. Copper bearing intrauterine contraceptives (IUCs) have each of these attributes except that they may cause uterine cramping pain, whereas the progestin releasing system has all except that it may infrequently cause androgenic symptoms. Nevertheless, despite the many benefits of IUCs, this contraceptive method is under-utilized in most countries in the world, with the notable exception of China. In the United States, less than 1% of women of reproductive age use an IUC for family planning. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | IUD, COPPER RELEASING | IUD SIDE EFFECTS | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | CONTRACEPTIVE METHODS CHOSEN | CONTRACEPTIVE USE-EFFECTIVENESS | FAMILY PLANNING | North America | Americas | Developed Countries | IUD | Contraceptive Methods | Contraception | Infections | Diseases | Reproductive Tract Infections | Contraceptive Usage | Contraceptive Effectiveness
Document Number: 314547

16.

Peer Reviewed

Title: IUDs and colonization or infection with Actinomyces.
Author: Westhoff C
Source: Contraception. 2007 Jun;75(6 Suppl 1):S48-S50.
Abstract: Pelvic actinomycosis is an extremely rare disease that can occur in women with a long duration of intrauterine device (IUD) use. This type of abscess is usually unsuspected and, thus, diagnosed and treated surgically; however, long-duration treatment with penicillin can be completely effective. While the occurrence of actinomycosis is well documented by case reports, it is not possible to quantify the risk during IUD use. Approximately 7% of women using an IUD may have a finding of Actinomyces-like organisms on a Pap test. The prognostic significance of this finding is minimal because of the lack of sensitivity and specificity and a low positive predictive value. In the absence of symptoms, women with Actinomyces-like organisms on a Pap test do not need antimicrobial treatment or IUD removal. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | LITERATURE REVIEW | WOMEN | IUD | PELVIC INFECTIONS | PAP SMEAR | BACTERIAL AND FUNGAL DISEASES | EXAMINATIONS AND DIAGNOSES | ANTIBIOTICS | TREATMENT | CONTRACEPTIVE REMOVAL | North America | Americas | Developed Countries | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Infections | Diseases | Laboratory Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs
Document Number: 316861

17.

Title: An analysis of surgically managed cases of pelvic abscess complicating unsafe abortion.
Author: Adesiyun AG; Ameh C
Source: Journal of Ayub Medical College, Abbottabad. 2006 Apr-Jun;18(2):14-16.
Abstract: This study was carried out to study the demographic variables, treatment options and mortality in cases of abortion related pelvic abscess. A retrospective study of patients that had pelvic abscess as a complication of unsafe abortion. The retrieved case files were scrutinized for the necessary information. The age ranged from thirteen years to forty six years, and teenagers accounted for 24.3% of the patients. About half of the patients, 51.4% were childless and parity ranged from zero to eight. The abortionists were mainly untrained personnel and the contraceptive prevalence rate was low, 5.4%. Most of the patient had conservative surgery and a significant number 94.6%, had blood transfusion. Maternal death of 18.9% was recorded with infection being the major cause. Unsafe abortion and its attendant complication is still a problem in Nigeria. High quality post abortion care will help a long way in saving many lives. (author's)
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | ADOLESCENTS, FEMALE | ABORTION | PELVIC INFECTIONS | GYNECOLOGIC SURGERY | SAFETY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Adolescents | Youth | Age Factors | Population Characteristics | Fertility Control, Postconception | Family Planning | Infections | Diseases | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Public Health
Document Number: 307231 Notification

18.
Peer Reviewed

Title: WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity.
Author: Latthe P; Latthe M; Say L; Gulmezoglu M; Khan KS
Source: BMC Public Health. 2006 Jul 6;6:177.
Abstract: Health care planning for chronic pelvic pain (CPP), an important cause of morbidity amongst women is hampered due to lack of clear collated summaries of its basic epidemiological data. We systematically reviewed worldwide literature on the prevalence of different types of CPP to assess the geographical distribution of data, and to explore sources of variation in its estimates. We identified data available from Medline (1966 to 2004), Embase (1980 to 2004), PsycINFO (1887 to 2003), LILACS (1982 to 2004), Science Citation index, CINAHL (January 1980 to 2004) and hand searching of reference lists. Two reviewers extracted data independently, using a piloted form, on participants' characteristics, study quality and rates of CPP. We considered a study to be of high quality (valid) if had at least three of the following features: prospective design, validated measurement tool, adequate sampling method, sample size estimation and response rate > 80%. We performed both univariate and multivariate meta-regression analysis to explore heterogeneity of results across studies. There were 178 studies (459975 participants) in 148 articles. Of these, 106 studies were (124259 participants) on dysmenorrhoea, 54 (35973 participants) on dyspareunia and 18 (301756 participants) on noncyclical pain. There were only 19/95 (20%) less developed and 1/45 (2.2%) least developed countries with relevant data in contrast to 22/43 (51.2%) developed countries. Metaregression analysis showed that rates of pain varied according to study quality features. There were 40 (22.5%) high quality studies with representative samples. Amongst them, the rate of dysmenorrhoea was 16.8 to 81%, that of dyspareunia was 8 to 21.8%, and that for noncyclical pain was 2.1 to 24%. There were few valid population based estimates of disease burden due to CPP from less developed countries. The variation in rates of CPP worldwide was due to variable study quality. Where valid data were available, a high disease burden of all types of pelvic pain was found. (author's)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | WHO | WOMEN | CLIENTS | REPRODUCTIVE HEALTH | PAIN | DYSMENORRHEA | MENSTRUATION DISORDERS | PELVIC INFECTIONS | EPIDEMIOLOGY | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Demographic Factors | Population | Program Activities | Programs | Organization and Administration | Health | Signs and Symptoms | Diseases | Infections | Public Health
Document Number: 306313

19.
Title: The intrauterine device: rethinking old paradigms.
Author: Morgan KW
Source: Journal of Midwifery and Women's Health. 2006 Nov-Dec;51(6):464-470.
Abstract: The United States continues to have one of the highest rates of unintended pregnancy and elective abortion in developed countries. Intrauterine devices (IUDs) available today offer women safe and highly effective contraception along with noncontraceptive benefits, yet IUDs remain underutilized in part because of outdated and biased information about the risks associated with this method of fertility control. New research demonstrates that IUD use does not increase the risk of pelvic infections or subsequent infertility. IUD use decreases the absolute risk of ectopic pregnancies. In light of this data, the IUD should be made available to women at low-risk for sexually-transmitted infections and should not be denied to women on the basis of parity or marital status. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | CRITIQUE | CLINICAL RESEARCH | WOMEN | NURSE-MIDWIVES | IUD | CONTRACEPTIVE SAFETY | CONTRACEPTIVE EFFECTIVENESS | PELVIC INFECTIONS | PREGNANCY, ECTOPIC | SEXUALLY TRANSMITTED DISEASES | PARITY | MARITAL STATUS | IUD SIDE EFFECTS | North America | Americas | Developed Countries | Research Methodology | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Safety | Public Health | Infections | Diseases | Pregnancy Complications | Reproductive Tract Infections | Fertility Measurements | Fertility | Population Dynamics | Nuptiality
Document Number: 309546

20.
Title: Microperforate hymen resulting in pelvic abscess.
Author: Sanfilippo AM; Mansuria SM
Source: Journal of Pediatric and Adolescent Gynecology. 2006 Apr;19(2):95-98.
Abstract: The patient presenting with abdomino-pelvic pain during pubertal development requires a gynecological evaluation. The absence of menses or presence of cyclic pain and appropriate pubertal milestones does not preclude assessment for a gynecologic etiology. We report on a patient with a microperforate hymen who ultimately developed bilateral hydrosalpinges and a severe pelvic infection. This case report is designed to make clinicians dealing with this age group aware of hymen-related defects, particularly microperforate hymen, and to consider them in their differential diagnosis. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CASE STUDIES | ADOLESCENTS, FEMALE | PERFORATIONS | PELVIC INFECTIONS | North America | Americas | Developed Countries | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Infections
Document Number: 299755

21.

Title: Prophylactic antibiotics for transcervical intrauterine procedures (Protocol).
Author: Thinkhamrop J; Laopaiboon M; Lumbiganon P
Source: Cochrane Database of Systematic Reviews. 2006;(1):[7] p.. ID: CD005637
Abstract: This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness and safety of antibiotic prophylaxis compared to placebo or no treatment in women undergoing transcervical intrauterine procedures. Antibiotic prophylaxis is the use of antibiotics for the prevention of infection. There are special considerations regarding the use of antibiotic prophylaxis in obstetric and gynecological procedures. Because the lower genital tract is a contaminated field, operation through or adjacent to this field leads to a moderate to high incidence of infection. There are established recommendations for using antibiotic prophylaxis in many procedures, for example, vaginal hysterectomy, abdominal hysterectomy, and cesarean section, which are major operative procedures. There are no clear recommendations for minor operative procedures such as dilatation and curettage for evacuation of conceptive products, fractional curettage for abnormal uterine bleeding, hysterosalpingography for infertility evaluation, and hysteroscopy for intrauterine cavity diagnosis and treatment. Since these minor operative procedures have only small areas of raw surfaces and tissue trauma, it is questionable whether or not antibiotic prophylaxis for these procedures has more benefit than harm. However, these procedures have a high possibility of ascending infection from the lower genital tract to the upper genital tract, especially for those procedures that pass through the endocervical canal into the uterine cavity. Therefore, antibiotic prophylaxis might have a role to prevent infection in these procedures. (excerpt)
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | LITERATURE REVIEW | DATA ANALYSIS | DATA COLLECTION | CLINICAL TRIALS | WOMEN | UTERINE EFFECTS | PELVIC INFECTIONS | ANTIBIOTICS | Research Methodology | Clinical Research | Demographic Factors | Population | Uterus | Genitalia, Female | Genitalia | Urogenital System | Physiology | Biology | Infections | Diseases | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 307790

22.
Peer Reviewed

Title: The intrauterine device in modern contraception: still an actuality?
Author: Tinelli A; Tinelli R; Malvasi A; Cavallotti C; Tinelli FG
Source: European Journal of Contraception and Reproductive Health Care. 2006 Sep;11(3):197-201.
Abstract: The intrauterine devices (IUD) is a contraceptive method largely used as an effective, safe and economic method of contraception; IUD efficacy is demonstrated to be about 97%, and copper IUD contraceptive failure frequency is about 0.8% for the first year of use, and this is about 0.1--0.2% for the progestin IUD. IUD benefits are different; it produces a well-defined contraceptive efficacy for long time, is useful for sexual activity and is rather free from common problems. However, IUD utilization is associated with an increasing risk of pelvic infection (0.5%) in the 8 years from initial use, and the common risk of pelvic inflammatory infection (PID) is about one to two cases per year; this risk, for copper IUD users, is 0.2--0.5% per year. The possible side effects of IUD use are: pelvic pain, irregular meshes, infections, bleeding and uterine perforation; we report a uterine perforation due to IUD migration in the Retzius space, diagnosed on transvaginal ultrasonography, confirmed on CT and removed by laparoscopy. In any case, the IUD remains the mainstay of family planning measures in developing countries but, unfortunately, its association with possible serious complications, change the cost--benefit link and restrict its utilization by a large part of the general population. (author's)
Language: English
Keywords:
ITALY | CRITIQUE | CASE HISTORIES | IUD COMPLICATIONS | IUD, COPPER RELEASING | IUD MIGRATION | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | UTERINE PERFORATION | ULTRASONICS | LAPAROSCOPY | Europe, Southern | Europe | Developed Countries | Data Collection | Research Methodology | IUD | Contraceptive Methods | Contraception | Family Planning | Infections | Diseases | Reproductive Tract Infections | Perforations | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses
Document Number: 307166

23.
Peer Reviewed

Title: HIV and gynaecological infections.
Author: Sebitloane MH
Source: Best Practice and Research Clinical Obstetrics and Gynaecology. 2005;19(2):231-241.
Abstract: Human immunodeficiency virus (HIV) infection primarily affects women during their reproductive years, and the co-existence of gynaecological infections is not surprising, given the fact that HIV is mainly acquired via heterosexual contact. Most gynaecological infections are themselves sexually acquired, and have the potential to increase the risk both of acquiring and transmitting the HI virus. As most sexually transmitted infections are asymptomatic, there is a need to improve methods of diagnosis and algorithms for early detection of sexually transmitted infections. HIV infection, however, particularly advanced disease, may alter the clinical presentation, course and response to conservative treatment for some of the sexually transmitted infections. (author's)
Language: English
Keywords:
SOUTH AFRICA | LITERATURE REVIEW | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | EXAMINATIONS AND DIAGNOSES | VAGINITIS | PELVIC INFECTIONS | HERPES GENITALIS | SYPHILIS | CHANCROID | GONORRHEA | CHLAMYDIA | TRICHOMONIASIS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Economic Development | Economic Factors | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Abnormalities | Infections | Sexually Transmitted Diseases | Reproductive Tract Infections
Document Number: 296920

24.

Title: Antibiotic prophylaxis for medical and surgical first-trimester induced abortion (Protocol).
Author: Snieders MN; Van Vliet HA; Helmerhorst FM; Low N
Source: Cochrane Database of Systematic Reviews. 2005;(2):[7] p.. ID: CD005217
Abstract: This is the protocol for a review and there is no abstract. The objectives are as follows: The objectives are: 1. To determine the effectiveness of universal antibiotic prophylaxis in preventing post-abortal pelvic infection. 2. To determine the most effective antibiotic regimen for preventing post-abortal pelvic infection. 3. To determine the most effective strategy for preventing post-abortal pelvic infection by comparing universal antibiotic prophylaxis with screen and treat policy, or with a combination of screen-and-treat plus prophylaxis. Each year 210 million pregnancies occur worldwide, of which an estimated 46 million end in an induced abortion [WHO 2003]. Abortion causes 65958 deaths and 4652171 DALYs per year worldwide, the vast majority due to unsafe illegal abortions in developing countries. Infection introduced through cervical instrumentation is probably responsible for a substantial amount of this morbidity and mortality. 13% of maternal deaths worldwide are due to unsafe abortion. A recognised iatrogenic complication of the procedure is post-abortal pelvic infection, which is presumed to be due to the introduction of bacteria into the upper genital tract by surgical instruments. Infectious agents causing post-abortal pelvic infection include exogenous bacteria, endogenous vaginal anaerobes or sexually transmitted cervical pathogens (Neisseria gonorrhoeae and Chlamydia trachomatis). (excerpt)
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | ABORTION | PELVIC INFECTIONS | ANTIBIOTICS | PREVENTION AND CONTROL | SCREENING | TREATMENT | Fertility Control, Postconception | Family Planning | Infections | Diseases | Drugs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses
Document Number: 307780 Notification

25.
Peer Reviewed

Title: Pelvic abscess in intrauterine device users.
Author: Tanir HM; Hassa H; Ozalp S; Kaya M; Oge T
Source: European Journal of Contraception and Reproductive Health Care. 2005 Mar;10(1):15-18.
Abstract: Objective To assess the causality between pelvic abscess formation and intrauterine device (IUD) use through a clinical study in a hospital. Method Sixty-two pelvic abscesses were retrospectively evaluated over a 7-year period. Patient records retrieved for the women enrolled in this study consisted of demographic characteristics, duration of IUD use and clinical management details. Results All the women were monogamous Muslim women without any suspicious sexual contacts, immunosupressive states, or drug use at the time of IUD insertion. In 10 cases (16.1%), a history of pelvic surgery was present. The mean age of the women was 36.1 � 2.3 years (range 19-50 years). Of the 62 women, 14 (22.6%) were current IUD users. The mean time interval for women using IUD prior to the diagnosis of pelvic abscess was 5.7 � 1.2 years (range 1-14 years). In all cases, a pelvic mass and abdominal pain constituted the referral signs and symptoms. All women received an initial antibiotic regimen comprising penicillin (24 mU/day), clindamycin (900 mg/day) and gentamycin (240 mg/day) in divided doses. In 38 cases (61.3%), medical treatment yielded a satisfactory clinical outcome, defined as a decrease in mass volume together with pain relief and a decrease in leukocytosis. Twenty-four cases (38.7%) underwent a subsequent surgical procedure, either laparotomy (n = 19) or laparoscopy (n = 5). The type of surgery ranged from abscess drainage to more radical approaches such as total abdominal hysterectomy and/or unilateral or bilateral salpingo-oophorectomy. There were no differences between those women responding to medical therapy and those who did not respond in terms of mean age, percentage of past pelvic surgery, gravidity, parity and the size of pelvic abscess. Conclusions A substantial number of women with an IUD were diagnosed as having a pelvic abscess within a 7-year period at the university clinic. Despite current knowledge that pelvic inflammatory disease and pelvic abscess are rarely encountered in long-term IUD users, the presence of an IUD should be investigated in cases with an initial diagnosis of pelvic abscess based on clinical and ultrasonographic evaluation, demonstrating mostly acquisition via sexually transmitted disease. (author's)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | IUD | PELVIC INFECTIONS | PELVIC INFLAMMATORY DISEASE | RISK FACTORS | Europe, Southeastern | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Infections | Diseases | Reproductive Tract Infections | Biology
Document Number: 287478

26.
Peer Reviewed

Title: Pelvic tuberculosis mimicking ovarian carcinoma.
Author: Tapisiz OL; Reyhan H; Cavkaytar S; Aydogdu T
Source: International Journal of Gynecology and Obstetrics. 2005 Jul;90(1):76-77.
Abstract: An increased Ca 125 level is found in up to 80% of women with late stage ovarian carcinoma, also it is used in relapse detection and treatment monitoring. However it has a low value in ovarian malignancy screening, since it is elevated in some other benign conditions. In literature, high serum Ca 125 levels in patients with pelvic peritoneal tuberculosis have been reported previously. Pelvic-peritoneal tuberculosis, increasing incidence especially in developing countries, is an extremely difficult disease to diagnose since it presents with nonspesific signs and symptoms such as ascites, pelvic and abdominal pain and mass, fever. These signs and symptoms mimic ovarian cancer. The current case supports this establishment. (excerpt)
Language: English
Keywords:
TURKEY | RESEARCH REPORT | WOMEN | OVARIAN CANCER | SIGNS AND SYMPTOMS | ABDOMINAL CRAMPS | PELVIC INFECTIONS | TUBERCULOSIS | Europe, Southeastern | Europe | Developing Countries | Demographic Factors | Population | Cancer | Neoplasms | Diseases | Infections
Document Number: 288807

27.
Title: [Maternal complications associated with type of delivery in a university hospital] Complica��es maternas associadas ao tipo de parto em hospital universit�rio.
Author: Nomura RM; Alves EA; Zugaib M
Source: Revista�de Saude Publica / Journal of Public Health. 2004 Feb;38(1):9-15.
Abstract: Objective is to analyze maternal complications associated to type of delivery, comparing cesarean (c-) section with vaginal delivery. Retrospective study of 1,748 deliveries carried out at a university hospital in the city of S�o Paulo, Southeastern Brazil, in which the newborn weighed more than 500 g. Maternal complications occurred during delivery as well as those diagnosed during puerperium that required further hospital admission were analyzed. Statistical analyses included Student�s t test and Fisher�s Exact test. Significance level was set at 0.05. C-sections were performed on 988 patients (56,5%). Hemorrhagic complications occurred in 1.2% of c-sections and in 0.8% of normal deliveries, with no statistically significant difference between both groups. Endometritis was observed in 0.4% of c-sections and in 0.1% of vaginal deliveries, without statistically significant difference. Two cases of puerperal infection evolved to hysterectomies, in the c-section group. There were no maternal deaths related to c-section. No associations were found between maternal complications and type of delivery the period analyzed. (author's)
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | RETROSPECTIVE STUDIES | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREGNANCY COMPLICATIONS | CHILDBIRTH | POSTCESAREAN SECTION | PUERPERAL DISORDERS | BLEEDING | PREGNANCY OUTCOMES | ENDOMETRITIS | PELVIC INFECTIONS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Pregnancy | Reproduction | Cesarean Section | Obstetrical Surgery | Surgery | Treatment | Signs and Symptoms | Reproductive Tract Infections | Infections
Document Number: 191452

28.
Title: Surgical management of pelvic abscess: laparotomy versus colpotomy.
Author: Aimakhu CO; Olayemi O; Odukogbe AA
Source: Journal of Obstetrics and Gynaecology. 2003 Jan;23(1):71-72.
Abstract: Early recourse to surgery in patients with pelvic abscess has decreased the need for long periods of intensive medical care, repeated hospital admissions for exacerbation of infection and reduced fertility. In this centre, the University College Hospital (UCH), Ibadan, Nigeria, the traditional management of diagnosed pelvic abscess had been drainage by colpotomy after initial resuscitation. Laparotomy is performed for cases with suspected bowel injury or uterine perforation and when the abscess is not confined to the pouch of Douglas. Laparoscopy and transvaginal ultrasound as well as combined transrectal sonographic and fluoroscopic guidance have been used in the diagnosis and treatment of pelvic abscess. These assist in reducing the morbidity and mortality associated with this condition and its treatment but are not readily available in our country. This study reviews the surgical management of this condition in our centre. (excerpt)
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CLINICAL RESEARCH | LONGITUDINAL STUDIES | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | COLPOTOMY | LAPAROSCOPY | PELVIC INFECTIONS | UTERINE PERFORATION | ULTRASONICS | GYNECOLOGIC SURGERY | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Economic Development | Economic Factors | Urogenital Surgery | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Endoscopy | Physical Examinations and Diagnoses | Examinations and Diagnoses | Infections | Diseases | Perforations | Biology
Document Number: 297721

29.
Title: Preserving fertility: an underappreciated aspect of sexual health.
Author: Cates W Jr
Source: Network. 2003;23(2):9-10.
Abstract: Because family planning professionals devote much of their careers to trying to help clients avoid unintended pregnancies, they may neglect the issue of unintended infertility. But efforts to better prevent, diagnose, and treat the main causes of unintended infertility could help preserve the fertility of millions worldwide. The main preventable causes of infertility are sexually transmitted infections (STIs), primarily chlamydial infection and gonorrhea (see article, page 12). Because these widespread and easily transmitted infections are often "silent" or asymptomatic, active screening of sexually active persons for these particular STIs is crucial. Otherwise, few women will realize that they have a fertility-threatening infection until they try to become pregnant and are unable to do so. Notably, this "prevention-first" approach to preserving fertility involves achieving the still difficult goal of integrating sexual and reproductive health services to address both unintended pregnancy and STIs. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | SUMMARY REPORT | WOMEN | SEXUALLY TRANSMITTED DISEASE PREVENTION | CHLAMYDIA | GONORRHEA | INFERTILITY | SCREENING | SEXUAL PARTNERS | TREATMENT | PELVIC INFECTIONS | REPRODUCTIVE HEALTH | Developed Countries | North America | Americas | Demographic Factors | Population | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Reproduction | Examinations and Diagnoses | Sex Behavior | Behavior | Health
Document Number: 187232

30.
Title: The levonorgestrel intrauterine system: a clinical perspective from the UK.
Author: Guillebaud J
Source: Annals of New York Academy of Sciences. 2003;997:185-193.
Abstract: The main contraceptive effects of this valuable product [the levonorgestrel intrauterine system (LNG-IUS)] are by endometrial suppression and changes to the cervical mucus and uterotubal fluid that impair sperm migration. The blood levels of LNG are very low, so progestogenic symptoms are uncommon. Most women still ovulate and in the remainder sufficient estrogen for health is produced from the ovary, even if they become amenorrhoeic, as many do; this is primarily a local end-organ effect and should be seen as a benefit. Although usable by selected nulliparae, it is ideal for the parous woman. It has unsurpassed efficacy, and return of fertility is rapid. Combining the best features of hormonal and intrauterine contraception, its gynecological benefits are impressive: the LNG-IUS user can expect a dramatic reduction in the amount and, after the first few occasionally troublesome months, in the duration of blood loss. Hemoglobin levels rise and dysmenorrhea is usually greatly benefited, unlike with current uterine ablation techniques. In perimenopausal women, it can protect the endometrium from overstimulation when estrogen replacement therapy (ERT) is added, by any chosen route. It thus provides a contraceptive modality of ERT with, usually, no bleeding and few progestogenic side effects�and is applicable before final ovarian failure. In summary, adverse side effects are few and in general they are not in the �hazardous� category. Regarding the admitted inconvenience of the first weeks of light postinsertion bleeding and the early phase low incidence of steroidal side effects: good counseling is paramount, since forewarned is forearmed! (author's)
Language: English
Keywords:
UNITED KINGDOM | LITERATURE REVIEW | COMPARATIVE STUDIES | WOMEN | IUD | LEVONORGESTREL | PELVIC INFECTIONS | CONTRACEPTION | BLEEDING | SAFETY | RISK ASSESSMENT | AMENORRHEA | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Infections | Diseases | Signs and Symptoms | Public Health | Health | Evaluation | Menstruation Disorders
Document Number: 189523


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