Hysterectomy

Question 1

What is the broad ligament ?

Answer 1

flat sheet of peritoneum associated with the uterus , fallopian tubes and ovaries.

Extends from the later pelvic walls on both sides.

Folds over internal female genitalia.

Question 2

Round ligament and Cancer ?

Answer 2

Round ligament of Uterus -
0 Cord like structure attached to posterior body of uterus.
- Extends laterally towards deep inguinal canal then passes through the inguinal canal .
- Inserts into fascia of the Labium majus.

Cancer can spread down here through the ligament - entering inguinal nodes.

Question 3

Indications of Hysterectomy ?

Answer 3

Ovarian neoplasm

pre cancerous changes in endomterium and cervix - just notes write properly.

merina coil ?
transactamic acid. - reduce menstrual bleeding - other ways to reduce.

Question 4

Fibroids and poplys

Answer 4

Fibroids - increase size of uterus.
(more likey to do total abdominal hysterectomy - not vaginal , or lascroscopic - as increased risk of hemorrage.

BRACCa1 AND 2 gene 0 increased risk of gynerological cancers - also increased risk of breast cancer.

Question 5

Endometrial cancer .

Answer 5

Risk factors

• excess estrogen

obesity - fat cell produce aromatase which converts precrusor to estrogen.

No child - no break from estrogen .

HPV - virus 0 also risk factor for other cancers
.

Question 6

Cervical cancer

• symptoms
• group
• affected
  cause

Answer 6

0 Develops in the cervix - entrance to the womb of vagina

0 Mainly affects sexually active women aged between 30 -45.

SYMPTOMS

early - usually none

later - abnormal vaginal bleeding - after or during sex , in between periods , new bleeding after menopause.

Screening

• smear test - aged btw 25 and 64. -

25 -49 - every 3 years

50 -64 - every 5 years.

sample checked for HPV - Human papillomavirus - look for abnormal cells

HPV causes almost all cervical cancers - strain 16 and 18 - cause abnormal cell changes in cervix .

sexually transmitted.

Question 7

Cervical cancer

• staging and grading.

Answer 7

STAGING

FIGO staging system
0 stage I: confined to the organ of origin

0 stage II: invasion of surrounding organs or tissue

0 stage III: spread to distant nodes or tissue within the pelvis

0 stage IV: distant metastasis(es)