Description, causes and Risk Factors:
Pelvic pain resulting from an old laceration of the broad ligament received during delivery.
ICD9 CODE: 620.6.
The main underlying pathology of the Allen-Masters syndrome is based on lacerations of the broad ligament. This sometimes incapacitating disease is expressed by persistent pelvic pain, dyspareunia and menstrual disturbances. Damage to muscle layers in the pelvis which allows the abnormally increased movement of the cervix. It often occurs after a traumatic surgical birth, induced abortion or excessive vaginal packing.
It is suggested that pelvic peritoneal defects may be causally related to endometriosis, the disease either attacking presumably previously altered peritoneal surfaces or causing peritoneal scarring, duplication, and reduplication secondary to the cyclic insults of the ectopic endometrium and thereby producing the appearance of traumatic lacerations. Further, it is suggested that when such defects are noted at laparoscopy, the presence of other associated pathologic abnormalities, including endometriosis, should be investigated.
Several different hypotheses have been put forward as to what causes this. Unfortunately, none of these theories have ever been entirely proven, nor do they fully explain all the mechanisms associated with the development of the disease. Thus, the cause of this disease remains unknown.
Risk factors Include, metaplasia, retrograde menstruation, lymphatic or vascular distribution, genetic predisposition, immune system dysfunctions, and environmental influences.
Symptoms include pelvic pain, dyspareunia, menstrual disturbances, sore back, pain during intercourse, and fatigability.
This makes diagnosing of this is challenge, and therefore an experienced gynaecologist should be able to recognize symptoms through talking with the woman and obtain a history of her symptoms. For this to be effective, it is important that the woman is honest with her physician about all of her symptoms and the pattern of these.
There are other tests, which the gynaecologist may perform. These include ultrasound, MRI scans, CA125, and gynaecological examinations. None of these can definitively confirm the disease (though they can be suggestive of the disease).
Treatment modes employed hitherto consisted of either suturing the peritoneal defect or of hysterectomy. The treatment should be individualized according to the needs of each patient. Generally, the most common approaches are with hormonal therapy, laparoscopic surgery and major surgical management.
For many women, management of this disease may be a long-term process. Therefore, it is important to educate yourself, take the time to find a good doctor, and consider joining a local support group.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
Related disease: Pelvic inflammatory disease
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