Pathology of the Female Reproductive Tract Flashcards
Cervical Pathology
Cervical Screening – Smear Test
Cervical Intra-epithelial Neoplasia (CIN)
Cervical Carcinoma
Endocervical Polyps
Cervical screening Smear test
View cervix and take sample of cells
Every 3 years from age 25 to 49 years.
Every 5 years from age 49 to 64.
After age 64, screening only if no previous smears or abnormal smears.
Aims to detect early disease stages before becomes invasive.
Human Papilloma Virus
Transmitted by sexual contact
Risk increases with increased numbers of sexual partners
No symptoms
Thought to be main cause of CIN and therefore cervical cancer
Cytology Screening of smear tests
Normal- routine 3/5 year re-smear
Abnormal- referred to colposcopy / May have biopsies taken
Cervical Intra-epithelial Neoplasia CIN
CIN is a microscopic lesion in that affects the cervix that could potentially develop into cervical cancer if left untreated
Cervical Cancer
2nd most common female malignancy Risk factors HPV, smoking, non attendance to CSP Symptoms Abnormal discharge and bleeding On examination the cervix appears abnormal
Treatment of Cervical Cancer
Treatment
Depends on stage either local excision or radical hysterectomy +/- chemoradiotherapy
Endocervical Polyps
Usually present with irregular vaginal bleeding ‘spotting’
Benign lesions
Can remove at hysteroscopy
Uterine Pathology
Menorrhagia Fibroids Endometritis and Pelvic Inflammatory Disease Endometriosis Endometrial Polyps Endometrial Cancer
Menorrhagia
“Heavy periods” >80ml blood loss Very common 1 in 20 women consult their GP a year Costing the NHS £7 million in prescriptions Causes DUB in 50% Fibroids, endometriosis, polyps
Menorrhagia treatment
Mirena coil Mefanamic and tranexamic acid combined oral contraceptive pill COCP Depo provera Endometrial ablation Hysterectomy
Fibroids (Leiomyomas)
Very common benign tumours
Arise from myometrium (uterine muscular wall)
Can present with heavy or painful periods, pelvic pain or distension
Treatment depends on symptoms and wishes for pregnancy
Endometritis and Pelvic Inflammatory Disease
Caused by Infections, usually sexually transmitted.
Can present with abnormal discharge, pain or bleeding.
Can be asymptomatic
Major cause of infertility
Endometriosis
Endometrial tissue in the wrong location i.e outside the endometrium
Very common benign condition
Can present with heavy or painful periods, pelvic pain, painful sex
Treatment depends on symptoms and often difficult
Endometriosis treatment
Treatment COCP Mirena Zoladex Surgery