Journal of the Royal Society of Medicine

ObjectivesTo determine the prevalence of multiple long-term conditions (MLTC) at whole English population level, stratifying by age, sex, socioeconomic status and ethnicity.DesignA whole population study.SettingIndividuals registered with a…

This is the second of a three-part series that charts the history of minimal access surgery from antiquity to current times. Although rapid developments in laparoscopic and robotic surgery have transformed surgical care over the last 30 yea…

This case highlights the risks of long-term unopposed oestrogen therapy after hysterectomy in a patient with a history of severe endometriosis.

Recent gynaecological studies show that childbirth, constipation, trauma and surgery cause injuries to autonomic nerves at different anatomical sites in the female pelvis resulting in endometriosis, adenomyosis and fibroids. Re-growth of ab…

Colonic mucosal involvement with endometriosis can result in gastrointestinal bleeding1. The mucosal abnormalities associated with colonic endometriosis may be difficult or impossible to identify at colonoscopy2.

The planning of effective services for patients with particular conditions demands an understanding of epidemiology, pathophysiology and therapy. In the case of chronic pain in general, and chronic pelvic pain in particular, elements of the…

The most informative method for assessing tubal patency in subfertile women is laparoscopy-and-dye. This investigation, however, puts a large burden on services and a screening test is needed that identifies a high likelihood of occlusion. …

All three patients had undergone extensive abdominal and pelvic surgery, and further abdominal and retroperitoneal surgery would have carried a substantial risk (see Table 1 for details). Figure 1 is the anterior nephrostogram from patient …

Diagnosis of functional abdominal pain requires exclusion of organic causes, and many patients undergo considerable investigation. A positive physical sign supporting a functional diagnosis could therefore be of benefit. Wheelchair use spec…