Genital abnormalities

Question 1

What is bicorunate uterus?

Answer 1

Partially divided uterus
May present as recurrent miscarriage, particularly in second trimester

Hysterosalpingogram to diagnose

Question 2

What is imperforate hymen? How does it present? Management?

Answer 2

Membrane at mouth of the vagina where the Mullerian and urogenital systems fuse may be imperforate

Apparent primary amenorrhoea
History of monthly lower abdo pain and swelling
Membrane bulging under pressure of dammed up menstrual blood (haematocolpos

Relieved by cruciate incision in the membrane

Question 3

What is female genital mutilation?

Answer 3

All procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons

Question 4

What is Type 1 FGM?

Answer 4

Partial or total removal of the clitoris and/or prepuce (clotiroidectomy)

Question 5

What is type 2 FGM?

Answer 5

Partial ot total removal of the clitoris and labia minor, with or without excision of labia majora

Question 6

What is type 3 FGm?

Answer 6

Narrowing of the vaginal orifice with creasing of a covering seal by curing and apposition gin the labia minor and/or the labia major with or without excision of the clitoris (infibulation)

Question 7

What is type 4 FGM?

Answer 7

All other harmful procedures to the female genitalia for non-medical purposes
Pricking, piercing, cauterisation, incising, scraping

Question 8

What are acute complications of FGM?

Answer 8

Death
Blood loss
Sepsis
Pain
Urinary retention
Tetanus
Hepatitis
HIV

Question 9

What are long-term sequelae of FGM?

Answer 9

Apareunia (inability to perform intercourse)
Superficial dyspareunia
Anorgasmia
Chornic pain
Keloid scar
Very slow urination
UTI
Haematocolpos
Subferitlity
Increased susceptibility to HIV
Emotional trauma

Question 10

What is complete androgen insensitivity syndrome

Answer 10

XY and very high Testosterone levels. The condition is due to testosterone being completely inactive so male internal genitalia or external genitalia do not develop. Sertoli cells are still present and produce anti-Mullerian hormone, so the Mullerian duct regresses meaning female internal genitalia are not produced. The lack of DHT (made from testosterone) causes female external genitalia to develop.

This leads to primary amenorrhoea

Partial androgen insensitivity syndrome leads to ambiguous genitalia