Laparoscopy In Women With Chlamydial Infection And Pelvic Pain
What to do before a woman's pelvic pain poses a problem for both diagnostic and therapeutic. The first step is to relate the pain to gynecological pathology. The second step is to differentiate the symptom "acute pain" symptom "chronic pain" for the latter is most often multifunctional. Acute pain is an emergency requiring a therapeutic approach which etiological treatment, sometimes surgical, allows rapid sedation. Chronic pain requires a comprehensive assessment of the lesions, the search for a cause somatic factors associated with maintenance and possibly an etiological treatment or, if symptomatic treatment quality.
It can usually guide the practitioner toward etiology and to choose among additional tests to substantiate the diagnosis. The characteristics of the pain must be specified: the topography, radiation, intensity, mode of onset and the evolution and cyclical. This information should be considered in the specific context of the patient. To do this, it should specify the age, pre-or postmenopausal status, characteristics of menstrual cycles, menstrual dates, type of contraception if used, and medical history, surgical, infectious, including pelvic inflammatory disease and / or sexually transmitted diseases.
Sometimes, in addition to pain, functional signs can coexist accompaniment of great value, either for a etiology such as nausea, vomiting, bowel dysfunction, burning urination and urinary frequency, or for a gynecological etiology such as sympathetic signs of , the presence of uterine bleeding and vaginal discharge. Finally, it should not omit to state the existence of symptoms (syndrome infectious anemia).
The typical report on research immediately hemodynamic instability (pallor, tachycardia, hypo-tension), that is a suspected acute hemorrhage. Inspection with the abdomen can note a good scars, such as a McCartney incision or umbilical akin to a laparoscopy, which can't be identified by the sufferer being a real surgery. Position analgesic is found or even an arch abdominal mass could be suggestive of uterine Adaline training or even a distended bladder. Gentle palpation concerns all abdominal quadrants ending with all the painful area selectively. In addition, it includes palpation with the lumbar fossa.
A defense or a pelvic contraction is desired. This review abdominopelvic systematically complemented by the exploration of the vulva and perineum, looking for swelling and / or malformation. The speculum examination under inconstant allows to relate the symptoms to the genital area. It allows you to specify the source of bleeding, the appearance of the cervix, mucus, the presence of the son of IUD, the existence of vaginal discharge, and perform as needed at the same time levies referred bacteriological and cytology. The vaginal examination associated with supra pubic palpation is crucial in identifying the painful area, pain in the mobilization of the uterus and the characteristics of uterine or Adaline mass (size, consistency and mobility). Reproduces the pain spontaneous pain.
The entire digital rectal examination. It features a diagnostic value, specifically in patients virgins, and eliminates rectal disease. The clinical examination allows an etiological diagnosis having a sensitivity of orientation estimated at 85%. It differs significantly with respect to the pathology. The positive predictive worth of clinical examination can also be good since it is about 80%. Thus, an abnormal physical examination can enhance the organic pathology. Poor people negative predictive worth of clinical examination is, conversely, its normality does in no way reassuring.
It can usually guide the practitioner toward etiology and to choose among additional tests to substantiate the diagnosis. The characteristics of the pain must be specified: the topography, radiation, intensity, mode of onset and the evolution and cyclical. This information should be considered in the specific context of the patient. To do this, it should specify the age, pre-or postmenopausal status, characteristics of menstrual cycles, menstrual dates, type of contraception if used, and medical history, surgical, infectious, including pelvic inflammatory disease and / or sexually transmitted diseases.
Sometimes, in addition to pain, functional signs can coexist accompaniment of great value, either for a etiology such as nausea, vomiting, bowel dysfunction, burning urination and urinary frequency, or for a gynecological etiology such as sympathetic signs of , the presence of uterine bleeding and vaginal discharge. Finally, it should not omit to state the existence of symptoms (syndrome infectious anemia).
The typical report on research immediately hemodynamic instability (pallor, tachycardia, hypo-tension), that is a suspected acute hemorrhage. Inspection with the abdomen can note a good scars, such as a McCartney incision or umbilical akin to a laparoscopy, which can't be identified by the sufferer being a real surgery. Position analgesic is found or even an arch abdominal mass could be suggestive of uterine Adaline training or even a distended bladder. Gentle palpation concerns all abdominal quadrants ending with all the painful area selectively. In addition, it includes palpation with the lumbar fossa.
A defense or a pelvic contraction is desired. This review abdominopelvic systematically complemented by the exploration of the vulva and perineum, looking for swelling and / or malformation. The speculum examination under inconstant allows to relate the symptoms to the genital area. It allows you to specify the source of bleeding, the appearance of the cervix, mucus, the presence of the son of IUD, the existence of vaginal discharge, and perform as needed at the same time levies referred bacteriological and cytology. The vaginal examination associated with supra pubic palpation is crucial in identifying the painful area, pain in the mobilization of the uterus and the characteristics of uterine or Adaline mass (size, consistency and mobility). Reproduces the pain spontaneous pain.
The entire digital rectal examination. It features a diagnostic value, specifically in patients virgins, and eliminates rectal disease. The clinical examination allows an etiological diagnosis having a sensitivity of orientation estimated at 85%. It differs significantly with respect to the pathology. The positive predictive worth of clinical examination can also be good since it is about 80%. Thus, an abnormal physical examination can enhance the organic pathology. Poor people negative predictive worth of clinical examination is, conversely, its normality does in no way reassuring.
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