Pelvic pain in transgender men taking testosterone: Assessing the risk of ovarian cancer.

Some guidelines on care for transgender men taking testosterone recommend oophorectomy to prevent ovarian cancer, while others recommend following guidelines for females. A review of the literature finds no strong evidence that transgender men are at increased risk for ovarian cancer. In transgender men taking testosterone without other risk factors, oophorectomy to prevent cancer is unnecessary.

Women's experience of low back and/or pelvic pain (LBPP) during pregnancy.

OBJECTIVE: to explore the experiences of women suffering low back and/or pelvic pain during pregnancy. DESIGN: a qualitative design using focus groups. Each group was recorded with a digital audio recorder and analysed using the Newell and Burnard framework for thematic analysis. SETTING: an urban maternity hospital. PARTICIPANTS: a self-selecting sample of 14 women who had taken part in a pilot randomised controlled trial investigating reflexology for pregnancyrelated low back and / or pelvic pain. MEASUREMENTS AND FINDINGS: the group discussions were guided by a pre-determined schedule of questions designed to investigate women's experiences of pregnancyrelated low back and / or pelvic pain. Three main themes emerged: KEY CONCLUSIONS: low back and/ or pelvic pain affected women physically and emotionally during pregnancy. Their attitudes towards, and knowledge about the conditions differed. Women used a range of self-help strategies for their symptoms and there was a general sense of dissatisfaction with routine advice and treatment, a finding supported by a growing body of research. IMPLICATIONS FOR PRACTICE: given that pregnancy-related low back and/ pelvic pain occur across the world, and affects the majority of pregnant women, heath care providers need to ensure that standard care provided is meeting women's needs. Health care professionals may require specific training in order to effectively provide individualised and evidence-based advice and support to pregnant women experiencing this pain.

Manejo de los conos vaginales en el tratamiento rehabilitador del suelo pélvico / Management of vaginal cones int he treatment of pelvic floor rehabilitation

El suelo pélvico (SP) es el conjunto de músculos encargados del soporte y mantenimiento de los órganos pélvicos en sus posiciones fisiológicas. A lo largo de la vida, esta estructura puede alterarse por situaciones como la gestación, el tipo de parto, las intervenciones quirúrgicas realizadas sobre la zona perineal, la obesidad o el estreñimiento, entre otras. La alteración de la funcionalidad del SP puede dar lugar a la aparición de patologías como los prolapsos genitales, las incontinencias urinarias o el dolor pélvico, que pueden ocasionar una importante alteración en la calidad de vida de la persona que las padece. Los conos vaginales (CV) suponen un método no farmacológico, económico, seguro y no invasivo para el tratamiento efectivo de la disfunción de la musculatura del SP, puesto que permite a la paciente aumentar la conciencia fisiológica de la musculatura de su SP al tiempo que promueve el aumento de la fuerza muscular. La matrona, como profesional íntimamente ligado a la atención de la mujer, forma parte del equipo multidisciplinar encargado del abordaje activo de las disfunciones pélvicas; por ello, debe ofrecer a la mujer información actualizada sobre los CV, asesorando sobre su uso y manejo y estableciendo programas de ejercicios y seguimiento individualizados para cada caso. La evidencia científica disponible acerca de la eficacia de los CV es limitada y señala que pueden existir otros métodos o tratamientos de eficacia semejante para el tratamiento rehabilitador del SP (AU)

The pelvic floor (PF) is a sheet of muscles and other tissues that support the pelvic organs in their physiological positions. Throughout women’s lives, these structures can become weak or be injured by events such as pregnancy, childbirth, surgery, overweight or constipation. PF dysfunction includes a group of disorders causing urinary incontinence, as well as genital prolapse or pelvic pain, and can significantly deteriorate women’s quality of life. Vaginal cones (VC) represent a non-pharmacological, economical, safe and non-invasive method for the treatment of PF dysfunction; they allow the patient to increase the physiological consciousness of the musculature of the PF while promoting an increase in the muscle tone. The midwife, as a professional intimately connected with women’s health care, works with the multidisciplinary team which treats pelvic dysfunctions; therefore, they need to provide updated information about the different methods for improving perineal function, including VC, and providing advice on their use and management, and establishing individualized exercise programs and tracking information for each case. The available scientific evidence on the effectiveness of the VC is limited and there may be other methods to treat PF dysfunctions (AU)

Qualidade de vida de mulheres com dor pélvica crônica / Quality of life of women with chronic pelvic pain

Os objetivos deste estudo transversal foram comparar a qualidade de vida e as características socioeconômicas de mulheres com e sem dor pélvica e investigar achados clínicos e cirúrgicos de mulheres com dor pélvica crônica. Os dados foram coletados em um hospital público, de Goiânia/GO, Brasil. A intensidade da dor foi aferida pela escala analógica visual e qualidade de vida avaliada pelo SF-36. A maioria das mulheres classificou a dor como intensa (52%) e conviviam com a dor há 8,8 (±7,7) anos. Mulheres do grupo com dor pélvica crônica apresentaram escores inferiores em todas as dimensões avaliadas pelo SF-36 (p< 0,05), exceto na dimensão saúde mental, quando comparado com o grupo sem dor. A correlação foi negativa (p=0,017) entre a intensidade da dor e a dimensão dor do SF-36. A dor pélvica apresentou impacto negativo significativo na qualidade de vida, com prejuízos para a saúde física e mental das mulheres.

The objective of this cross-sectional study was to compare the quality of life and socioeconomic characteristics of women with and without pelvic pain and investigate clinical and surgical findings about women with chronic pelvic pain. Data were collected in a public hospital in Goiânia, Goiás, Brazil. Pain intensity was measured using the visual analogical scale, whereas quality of life was assessed through the SF-36. Most women classified pain as intensive (52%) and lived with pain for 8.8 (±7.7) years. Women belonging to the group of chronic pelvic pain scored less in all dimensions evaluated by the SF-36 (p< 0.05), except for the mental health dimension, when compared to the painless group. Correlation was negative (p=0,017) between pain intensity and the SF-36 bodily pain dimension. Pelvic pain presented significant negative impact on quality of life with losses to the physical and mental health of women.

A meta-ethnography of patients' experiences of chronic pelvic pain: struggling to construct chronic pelvic pain as 'real'.

AIM: To review systematically and integrate the findings of qualitative research to increase our understanding of patients' experiences of chronic pelvic pain. BACKGROUND: Chronic pelvic pain is a prevalent pain condition with a high disease burden for men and women. Its multifactorial nature makes it challenging for clinicians and patients. DESIGN: Synthesis of qualitative research using meta-ethnography. DATA SOURCES: Five electronic bibliographic databases from inception until March 2014 supplemented by citation tracking. Of 488 papers retrieved, 32 met the review aim. REVIEW METHODS: Central to meta-ethnography is identifying 'concepts' and developing a conceptual model through constant comparison. Concepts are the primary data of meta-ethnography. Two team members read each paper to identify and collaboratively describe the concepts. We next compared concepts across studies and organized them into categories with shared meaning. Finally, we developed a conceptual model, or line of argument, to explain the conceptual categories. RESULTS: Our findings incorporate the following categories into a conceptual model: relentless and overwhelming pain; threat to self; unpredictability, struggle to construct pain as normal or pathological; a culture of secrecy; validation by diagnosis; ambiguous experience of health care; elevation of experiential knowledge and embodiment of knowledge through a community. CONCLUSION: The innovation of our model is to demonstrate, for the first time, the central struggle to construct 'pathological' vs. 'normal' chronic pelvic pain, a struggle that is exacerbated by a culture of secrecy. More research is needed to explore men's experience and to compare this with women's experience.

[Causes of pain in obstetrics]. / Etiologie des douleurs en obstétrique.

For women, the childbearing period is a source of pain related to dysmenorrhoea, childbirth, abortion, gynaecological diseases, etc. Physiologically, female sex hormones influence pain modulation. Whatever its cause, appropriate evaluation and treatment should be offered to relieve these women.

Vaginal diazepam use with urogenital pain/pelvic floor dysfunction: serum diazepam levels and efficacy data.

Vaginal diazepam is used off-label for pelvic floor dysfunction and urogenital pain, but serum levels with efficacy have not been reported until now. One clinician evaluated 21 women for overall, levator, and vulvar pain pre- and one-month post-daily diazepam treatment. One-month post-treatment assessments and serum diazepam levels were done; 62% were moderately or markedly improved. Levator examination pain scores were significantly improved, and vulvar pain scores decreased post-treatment. Serum diazepam levels were within normal limits. Vaginal diazepam may be helpful in treating pelvic floor/urogenital pain conditions.

Ovarian torsion in a 23-year-old female with pelvic pain.

Ovarian torsion is infrequently seen in the emergency department, however, a delay in diagnosis and treatment can lead to necrosis and loss of the ovary (E. D. Shraga & M. Blanda, 2008). A patient with pelvic pain diagnosed with ovarian torsion is presented in this article. The diagnosis and treatment of ovarian torsion is discussed to help the advanced practice nurse gain a better understanding of this frequently missed problem.

Pain at midlife.

Although menopause is a normal developmental milestone through which all women pass, the transition has been long associated with chronic pain conditions that may be more accurately viewed as secondary to aging. Clinicians need to understand management of pain problems women may experience. This article examines pain syndromes including headache, back pain, osteoarthritis, pelvic pain, vulvo-vaginal pain, and burning mouth syndrome.

Use of pelvic tilt exercise for ligament pain relief.

The purpose of this study was to test the effectiveness of a pelvic (hip) tilt exercise in relieving ligament pain during pregnancy. A multiple pain measurement approach was used. The intensity of ligament pain was decreased as indicated by scores on three of four pain intensity measures. The duration of ligament pain also was reduced, although not significantly. Mean scores on all measures of ligament pain intensity, duration, and frequency were lower after the exercises were initiated. Verbal reports from subjects indicated that they had received effective pain relief from the exercise. Thus, pelvic (hip) tilt exercise appears to be effective in reducing ligament pain intensity and, to a lesser extent, pain duration. As a nurse-midwifery strategy, this exercise promotes patient/client comfort and facilitates self-care in the relief of ligament pain during pregnancy.