gyn-benign uterine
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| 5 benign uterine conditions | endometriosis, adenomyosis, uterine fibroids, endometrial polyps, uterine anomalies
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| the presence and growth of the glands and stroma of the lining of the uterus in an aberrant location | endometriosis
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| the growth of endometrial glands and stroma in the uterine myometrium (at least 2.5mm from the basalis layer of the endometrium) | adenomyosis
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| also known as leiomyomas, or myomas, benign tumor of muscle cell origin found in any tissue that contains smooth muscle | uterine fibroids
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| localized overgrowths of endometrial glands and stroma that project BEYOND the surface of the endometrium | endometrial polyps
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| endometriosis is an ______-dependent dz and is mainly in ________ women | estrogen; pre-menopausal
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| in endometriosis, ovaries are involved in how many pts? | 2/3 of pts
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| sxs of endometriosis? | CYCLIC pelvic pain, 2ndary dysmenorrhea, pelvic heaviness, welling, bloating, abnormal bleeding, dyspareunia, cyclic abd pain, intermittent constipation/diarrhea, urinary frequency/dysuria, hematuria
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| classic sign of endometriosis? | fixed retroverted uterus w/ tenderness and scarring posteriorly
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| dx of endometriosis? | direct visualization of lesions w/ histologic confirmation (laparoscopically)
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| tx of endometriosis? | induction of amenorrhea is goal (danazol, GnRH agonists, OCPs, progestins). surgical therapies (for failed med therapy): conservative (cautery, excision), definitive (hysterectomy w/ bilateral salpingo-oophorectomy and removal of all visible implants)
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| 3 types of GnRH agonists | Lupron (inj), Synarel (intranasal), Zoladex (subQ implant)
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| when does anenomyosis occur? | when basal is layer of endometrium invades myometrium
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| adenomyosis is most often seen in ______ women | parous
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| most common type of adenomyosis? | diffuse involvement of ant and post walls of uterus. spongy appearance
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| sxs of adenomyosis? | usually asxs or have minor sxs (dysmenorrhea and menorrhagia, occasionally dyspareunia)
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| clinical dx of adenomyosis? | diffuse enlargement of uterus (2-3x normal size), uterus globular and tender right before and during menses, diff in tenderness and consistency of uterus from one pelvic exam to another
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| most helpful imaging study of adenomyosis? | MRI
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| tx of adenomyosis? | tx anemia (if cause), HYSTERECTOMY is the only definitive tx
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| leiomyomas are _____ tumors of ______ cell origin | benign, muscle
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| what is the most common benign pelvic tumor and when do they commonly occur? | leiomyomas, 5th decade of life (40s)
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| 5 types of fibroids? | intramural, submucosal, subserosal, broad ligament, parasitic
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| sxs of fibroids? most common sx? | abnormal bleeding and pain. PRESSURE IS MC SX. most women are asxs, rapid growth is VERY worrisome
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| dx of fibroids? | on PE (bimanual--uterus is enlarged, firm, and irregular)
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| preferred imaging of fibroids? | US--always use!
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| tx of fibroids? | observation--pelvic exam every year and yearly sono is small. Meds (GnRH agonists-Lupron), myomectomy, hysterectomy
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| localized overgrowths of endometrial glands and stroma that project beyond the endometrium | endometrial polyps
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| bases of endometrial polyps? (2) | sessile (wide), pedunculated (narrow)
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| sxs of endometrial polyps? | most are asxs, abnormal bleeding, polyp may protrude through external os
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| dx of endometrial polyps? which is most useful? | labs (CBC, TSH, prolactin, FSH), US, SALINE SONOHYSTEROGRAM (most useful), hysteroscopy
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| tx of endometrial polyps? | surgical removal by curettage, always send for pathology
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| uterine malformation is the result of an abnormal development of the _______ ducts during embryogenesis | Mullerian
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| sxs of uterine anomalies? | amenorrhea, manual obstruction, ectopic pregnancy, recurrent miscarriage or infertility
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| uterus not present (class I) | Mullerian agenesis
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| single vagina, single cervix, single horn of uterus w/ fallopian tube | unicornuate uterus (class II)
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| both mullein ducts develop but fail to fuse | uterine didelphys (class III)
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| only the upper part of that part of the Mullerian system that forms the uterus fails to fuse ("heart-shaped" uterus) | bicornuate uterus (class IV)
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| mullerian ducts have fused by partition is still present (septum) | septate uterus (class V)
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| uterine funds displays a concave contour towards the uterine cavity | arcuate uterus (class VI)...often considered a normal variant
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| T-shaped uterus, result of exposure to DES | DES uterus (class VII)
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