Chapter 11: Structural Disorders and Neoplasms of the Reproductive System

Question 1

What is the typical alignment of the uterus?

Answer 1

slight anteversion – fundus points towards belly button

Question 2

What are 5 types of disorders of uterus structure?

Answer 2

1. retroversion: fundus of uterus points towards head or slightly back towards spine
   * occurs 2 months postpartum – should returnt o normal
   * 1/3 do not return – may make future conception more difficult
   * rarely symptomatic
2. prolapse
   * mild or complete
   * complete – painful sex, urinary incontinence
3. cystocele: protrusion of bladder into vagina
   * often accompanies uterine prolapse
   * feels like something is in vagina
   * issues with voiding or stooling – may have trouble emptying
4. rectocele: herniation of rectal wall through vagina
   * needs to be repaired surgically
   * often accompanies uterine prolapse
   * feels like something is in vagina
5. genital fistulas: perforations between organs and genital tract organs

Question 3

What are ovarian cysts?

Answer 3

• benign cysts that are often associated with menstrual cycle
• asymptomatic unless ruptured –> severe abdominal pain
• PCOS – endocrine imbalance due to multiple cysts on ovaries which results in high estrogen
• dermoid cysts – comprised of hair and bone that develop in childhood
• ovarian fibromas – comprised of connective tissue

Question 4

What are uterine polyps?

Answer 4

• endometrial or cervical in origin
• benign polyps that rarely recur after removal
• most common in multip women 40+
• unknown etiology

Question 5

What are leiomyomas?

Answer 5

• AKA fibroid tumors, fibromas, myomas, fibromyomas
• most common benign tumor
• tumors arise from muscle tissue of uterus
• rarely malignant
• growth influenced by ovarian hormones
• spontaneously shrink after menopause
• mostly asymptomatic

Question 6

How are leiomyomas managed?

Answer 6

• medications – gonadotropin release hormone agonists (reduce size), NSAIDs
• uterine artery embolization (UAE) – cuts off blood flow to fibroid
• surgery – laser, myomectomy, hysterectomy

Question 7

What are Bartholin cysts?

Answer 7

• most common benign lesions of the vulva
• obstruction of the Bartholin duct, causing it to enlarge
• recurrence in women is common
• treatment is marsupialization – formation of new duct for drainage (permanent opening)

Question 8

What is vulvodynia?

Answer 8

vulvar pain

Question 9

What is a major risk factor in development of malignant cancers of endometrium, cervix, ovaries, vulva, vagina, and uterine tubes?

Answer 9

obesity

Question 10

What is endometrial cancer?

Answer 10

• malignant cancer in the endometrial tissue
• hormone imbalance is the most significant risk factor
• s/s: abnormal uterine bleeding

Question 11

What is ovarian cancer?

Answer 11

• malignant cancer of the ovaries
• definitive screenings do not exist – usually diagnosed in advance stage
• s/s: vague, but abdominal bloating is one
• white women of North American or Northern European descent and older women are at highest risk

Question 12

What is cervical cancer?

Answer 12

• malignant cancer of the cervix
• 90% caused by HPV
• most reliable method to detect preinvasive cancer = Pap smear
• confirmation of cervical cancer = colposcopy and biopsy

Question 13

What is vulvar cancer?

Answer 13

• malignant cancer of vulva
• slow growing, slow extending, and late to metastasize
• most common site = labia majora

Question 14

What is vaginal cancer?

Answer 14

• malignant cancer of vagina
• most at risk = women 70 - 90
• most lesions are squamous cell carcinomas
• may be caused by chronic vaginal irritation, vaginal trauma, and genital viruses

Question 15

What is uterine tube cancer?

Answer 15

• malignant cancer of uterine tubes
• most at risk = women 50 - 60
• unknown etiology

Question 16

How likely is cancer to occur during pregnancy?

Answer 16

relatively infrequently – 1 out of 100 women

Question 17

What are the types of cancer that may occur during pregnancy?

7 types

Answer 17

1. breast cancer
2. cervical cancer
3. leukemia – cancer of blood forming tissues
4. Hodgkin disease/lymphoma – WBCs grow uncontrollably, causing swelling of lymph nodes
5. melanoma
6. thyroid cancer
7. colon cancer

Question 18

If a woman is on cancer treatments but wants to get pregnant, what is the recommended timeline for her to conceive?

Answer 18

wait at least 2 years after the end of therapy before conceiving

Question 19

What is gestational trophoblastic disease (GTD)?

Answer 19

• malignant tumors that develop during abnormal pregnancies
• most curable gynecologic malignancy
• follow HcG (human chorionic gonadotropin) hormones for at least 1 year