Pelvic Pain Flashcards
What is the difference in symptoms between a Batholin’s cyst and a Bartholin’s abscess?
Cyst = painless Abscess = painful
What is the main treatment for a Bartholin’s abscess?
Broad spectrum ABX
Define Lichen Sclerosus
AI condition affecting post-menopausal women
Give 2 symptoms of Lichen Sclerosus
Pruritis
Excoriation
Give 2 signs of Lichen Sclerosus
Whitened vulva
Narrow entry to vagina
What is the treatment for Lichen Sclerosus ?
Potent topical steroid (Dermovate)
Which virus usually causes genital herpes?
HSV-2
What is the main treatment for genital herpes?
Oral acyclovir
What causes cervical ectropion?
Columnar cells from canal everted to cervix
Give 2 ways in which a symptomatic cervical ectropion may be treated
Cautery
Silver nitrate
Although usually asymptomatic, give 2 possible symptoms of cervical polyps
PCB
PMB
What is a uterine fibroid?
Benign tumours of myometrium which are oestrogen dependent
How is a uterine fibroid diagnosed and worked up?
Dx on clinical suspicion
Confirm on USS
MRI to plan management
Which 2 surgeries may be used to manage a uterine fibroid?
Myomectomy
Hysterectomy
What is UAE in the management of uterine fibroids?
Uterine Artery Embolization: minimally invasive, UAs occluded by bio-degradable particles
Define PID
Ascending infection from the cervix which can be caused by STIs
Which STI commonly causes PID?
Chlamydia
Give 4 tests used in the diagnosis of PID
- FBC + CRP
- MSSU (exclude UTI)
- STI swabs
- TVU (for tube-ovarian abscess)
Which 2 antibiotics are used to treat PID?
Doxycycline and Metronidazole
What is a potential management option in symptomatic hydrosalpinx?
Bilateral salpingectomy
What are the 4 main types of benign ovarian cyst?
Functional
Dermoid
Epithelial
Endometrioma
What are the general thresholds for ovarian cyst removal by surgery?
> 6cm and/or symptomatic
What is the treatment of a dermoid cyst?
Cystectomy/oophrectomy
What are the two subtypes of function cyst?
Follicular and luteal
What are the two subtypes of epithelial cyst?
Serous
Mucinous cyst adenoma
Define endometriosis
Prescence of endometrial tissue outside of the uterus
What are chocolate cysts?
Endometriomas (cyst containing endometrial tissue) which bleeds cyclically causing pooling of brown coloured blood
Why is endometriosis important in the investigation of women of reproductive age with pelvic pain?
This condition absolutely must be ruled out as a cause of chronic pelvic pain in women reproductive age
Give 3 symptoms of endometriosis
Dysmenorrhoea
Dyspareunia
Pelvic pain
What appearance may the uterus have in endometriosis?
Fixed tender retroverted uterus
Which tumour marker is often increased in endometriosis?
Ca125
What is the gold standard investigation for endometriosis?
Laparoscopy and biopsy
Give 3 medical management options for endometriosis
NSAIDs
Progestogens
COCP
Which medical treatment is given pre-operatively in endometriosis?
GnRH analogue
Define vulvodynia
Sensation of vulval burning and soreness, no skin features or itching
What is the medical treatment for vulvodynia?
Low dose Tricyclic antidepressants
What is chronic pelvic pain syndrome?
Intermittent/constant lower abdo pain >6 months with no identifiable cause
