Reproductive Flashcards
What is pelvic inflammatory disease – PID?
Bacterial infection of female upper genital tract – uterus, uterine tubes + ovaries
Spread up from vagina/cervix
What is the cause of pelvic inflammatory disease?
One in four cases it’s a result of an STI - chlamydia/gonorrhoea
Can be from bacteria normally present in vagina E.G after childbirth or having an IUCD fitted
Affect sexually active woman aged 15 to 24
What are the complications of a pelvic inflammatory disease?
Scarring/narrowing of uterine tubes which can lead to atopic pregnancy or infertility
What is the incidence of infertility?
One and seven couples in the UK – 35 million people
What are the three types of causes of infertility?
Functional anatomical or physiological
What is polycystic ovary syndrome (PCOS)?
Ovaries that contain many cysts – two times more than normal
Cysts are no bigger than 8 mm – below surface of ovaries
What are cysts in ovaries?
cysts are eggs – containing follicles – not develop properly – hormonal abnormalities 
What is the incidence of PCO and PCOS?
PCO – very common – 20% of women
PCOS – very common – 5 to 10% of women
What are the features of PCOS/PCOD?
Anovulation – resulting in irregular menstruation, amenhhroea
Excessive amounts or Effects of androgenic hormones resulting in acne and Hirsutism 

Insulin resistance
Ovaries are appearing polycystic on ultrasound is common but not an absolute requirement
symptoms and severity of the syndrome vary greatly among affected women
What are the treatments of PCOS/PCOD?
A minor surgical procedure called laparoscopic ovarian drilling - LOD
Lifestyle changes – balanced diet
Drug treatment
What are Anatomical variations?
Bicornate
Malformation of the uterus
Bicornate – two horns form at the top of the uterus
What is the incidence of a bicornate?
0.1–0.5% of women
Why are pregnancies considered high risk with bicornates?
Considered high risk and require extra monitoring because of association with poor reproduction potential e.g. stillbirth/malformation
What are fibroids?
Uterine fibroid - leiomyoma - benign tumour from smooth muscle tissue - originates from smooth muscle layer of uterus
What is the incidence of fibroids?
20 to 50% of women child bearing age
What are the sizes of fibroids + how many are usually present?
Range in size – large 70%
Coin – melon
After multiple – if too many to count – diffuse uterine leiomyomatosis
What are the two types of ovarian cysts?
Functional
Pathological
What is a functional ovarian cyst?
Functional- Harmless; form as part of menstrual cycle; most common
Pathological; benign or malignant; dermoid - (mature cystic adenoma - under 40)
- cystadenoma over 40
What is a dermoid ovarian cyst?
Ovarian teratoma tumour – could consist of different tissue types E.G fat, bone, hair;
Usually benign but may be removed due to size – up to 15 CM
What is a cystadenoma ovarian cyst?
Develops from cells covering the outer part of Overy;
Some small other large – up to 30 cm;
Risk of rupture ovarian torsion – due to cyst blocking it’s blood supply
What is cervical carcinoma?
Cervical carcinoma/cancer is a malignant neoplasm arising from cells originating in the cervix uteri
Where may the cervical carcinoma metastasise?
Abdomen lungs or elsewhere
What is the prognosis for cervical carcinoma?
100% survival rate diagnosed at stage one
30 to 40 years; rare under 25
What are the two main types of carcinoma of the cervix?
Squamous cell – most common; develops from the skin like squamas cells that covers the cervix
Adenocarcinoma - Less common; develops from mucus producing glandular cells within cervical canal
What is ovarian carcinoma?
Cancerous calls arising from cells in or around the ovary
What is the incidence of ovarian carcinoma?
7100 UK diagnosis per year
Rare under 40
Most common in postmenopausal women - Typically over the age of 50
Most are benign – only 1 to 5 masses in menustrating women cancerous; 1:2 post menopause
Epithelial – Arises from cells that line/cover the ovaries – most common
What is the prognosis of ovarian carcinoma?
Per prognosis
Lacks any clear early detection or screening

Most cases are not diagnosed until we have reached advanced stages
60% of women presenting with this cancer has stage 3 or 4 and it has already spread beyond the ovaries
What are the symptoms of a ovarian carcinoma?
Bloating
Pelvic pain
Difficulty eating
Frequent urination
Different types of trauma to the male reproductive system?
And what may be the result?
Blunt trauma – 75%
Penetrating
Can result in a partial or complete ripping of the testicle
loss of entire testicle
or injury to vascular structures
How does a penile fracture occur?
Occurs whilst select most commonly during sexual intercourse
The tunica albuginea stretches - in trauma this is breached causing injury to the carvernosa corpora
most severe cases the urethra and associated structures involved
How does testicular torsion occur?
Occurs when the spermatic cord twists cutting off the testicles blood supply
What increases the incidence of testicular torsion?
Congenital malformation known as bell clapper deformity – testes is inadequately affixed to the scrotum allowing it to move freely on its axis
 L>R
13-17 year olds
Rare over 30
Can affect babies, newborn + unborn
Congenital
What are the clinical signs of testicular torsion?
Sudden onset of scrotal pain
Nausea and vomiting
Infection and inflammation
Young men plus adolescence
Surgical emergency is urethritis or UTI are ruled out completely
Reversible damage 6 hours after onset - diagnosis + treatment to reduce necrosis

What is a Hydrocele?
So this food collection with the layers of the tunica intima vaginalis surrounding the testicle/s
Vary in size
Normally painless and harmless
Large can cause discomfort

Causes of a hydrocele?
Acquired or congenital
Physical trauma
Testicular carcinoma
Epididymitis
Testicular torsion
Generally unknown
What is a varicocele?
Collection of dilated blood vessels in the spermatic cord in the scrotum next to/above one or both testicles
Like varicose veins
Valves and veins malfunction; backflows of blood is not prevented which causes pooling and enlarges veins
What is the incidence of Varicocele?
common 1:7
15–25 years
Less common in the testicle
Left over right
What is a benign prostatic enlargement - hyperplasia – BPH
Enlargement of prostate
Extremely common – considered normal part of aging
What are the Symptoms of benign prostatic enlargement?
Urinary hesitancy
Frequent urination
UTI
Urinary rentention
What is the result of a benign prostatic enlargement?
Nodules Compress the urethra – partial or virtually complete urinary tract obstruction
What is the incidence of a benign prostatic enlargement?
age 60. - 50% of a men
age 90. –90% of men
 How does prostate carcinoma develop?
Develops slowly – may not be aware of presents for many years
Matasize via lymph 
How is prostate carcinoma diagnosed?
PS symptoms
Physical exam
PSA
Biopsy
What are the symptoms of a prostate carcinoma?
First sign often bone mets
What is the incidence of prostate carcinoma?
Most common cancer in men UK over 40,000 cases diagnosed every year
Most common type – adenocarcinoma
Testicular carcinoma incidence?
Affects main 15 to 49
One of the less common cancers
Senimoma 30-40years
Teratoma 20-30 years
Imperfectly just said the testes have a 20 to 30% higher chance of developing carcinoma
Excellent prognosis if not later stage due to metastases via lymph
