Structural Disorders and Neoplasms of the Reproductive System Flashcards
Alterations in pelvic support
Uterine displacement and prolapse
Cystocele and rectocele
-Vaginal pessary
-Surgical repair
Urinary incontinence
Genital fistulasOvarian Cysts
Follicular cysts
Corpus luteum cysts
Theca-lutein cysts
Polycystic ovary syndrome (PCOS)
Other benign ovarian cysts and neoplasms - Dermoid cysts, Ovarian fibromas
(women prone to cysts can be on birth control pills)
–> Polycystic ovary syndrome (PCOS)
cysts on ovary
increase levels of estrogen, testosterone
increase hair on face, irregular cycles, harder to get pregnant
persary
helps to hold uterus where its supposed to be
Uterine polyps
Endometrial or cervical in origin
Tumors on pedicles (stalks) arising from the mucosa
Polyps rarely recur after removal
Most common in multiparous women older than age 40
Leiomyomas
Also called fibroid tumors, fibromas, myomas, or fibromyomas
Slow-growing benign tumors arising from the muscle tissue of the uterus
Rarely become malignant
Growth influenced by ovarian hormones
Spontaneously shrink after menopause
Most women are asymptomatic
(cause dysfunctional uterus bleeding)
Leiomyomas management
Medical management - Medications, Uterine artery embolization (UAE)
Surgical management - Laser surgery, Myomectomy, Hysterectomy
Bartholin cysts
Most common benign lesions of the vulva
Caused by obstruction of the Bartholin duct, causing it to enlarge
Recurrence in women is common; permanent opening for drainage may be recommended - Marsupialization**
Vulvodynia
Vulvar pain
Cancer of the endometrium
Most common malignancy of reproductive system
Hormone imbalance most significant risk factor
Metastasis through lymphatic system in pelvis and through blood to liver, lungs, and brain
- CA-125 antigen
- Transvaginal ultrasound
Cancer of the ovary
Second most frequently occurring reproductive cancer Symptoms vague Definitive screening tests do not exist Often diagnosed in advanced stage (diagnosised in late staged)
ovary cancer tx
dictated by stage of disease at time of initial diagnosis Surgical removal Cytoreductive surgery Antineoplastic surgery Chemotherapy
Cancer of the Cervix
Third most common reproductive cancer
Incidence of invasive cancer has decreased 50% over past 30 years
Incidence of preinvasive cancer has increased
Most reliable method to detect preinvasive cancer is the Pap test
Diagnosis identified by use of: Colposcopy, Biopsy, Conization
(caused by HPV 70-80%)
(pap smear to test: guidelines: sexually active 3 years later or 21)
Cancer of the Cervix management
Cryosurgery
Laser ablation
Electrosurgical excision
invasive cancer of the cervix
Radical hysterectomy External radiation therapy Internal radiation therapy Pelvic exenteration Chemotherapy
cancer of the vulva
Fourth most commonly occurring gynecologic cancer—5% of female genital malignancies
Grows slowly, extends slowly, and metastasizes fairly late
Survival rates are greater than 90% for all stages if nodes are negative
Most common site for vulvar lesions is on the labia majora
cancer of the vulva
Laser surgery
Cryosurgery
Electrosurgical excision
Vulvectomy
cancer of the vagina
Vaginal carcinomas account for less than 2% of gynecologic malignancy
Peak incidence from 50 to 70 years of age
Most lesions are squamous cell carcinomas
May be caused by chronic vaginal irritation, vaginal trauma, and genital viruses
cancer of the uterine tubes
Primary carcinoma of the uterine tube is rare
Peak incidence between ages 50 and 60 years
Cause unknown
cancer and pregnancy
Occurs with relative infrequency during the reproductive years
Therapeutic issues are complex
-Continue or terminate pregnancy
-Timing of therapies such as chemotherapy, radiation, and surgery are affected
Most frequent types of cancer that occur during pregnancy
Breast cancer Cervical cancer Leukemia and lymphomas Melanomas Thyroid cancer Colon cancer
Other gynecologic cancers
Cancer of the vulva Cancer of the vagina Cancer of the uterus Cancer of the uterine tube Cancer of the ovary
cancer therapy and pregnancy
Timing of therapy
Chemotherapy
Radiation therapy
pregnancy after cancer treatment
Increase in the number of childhood and adolescent cancer survivors
Delay of 2 years from end of therapy to conception is advised
Gestational Trophoblastic Disease (GTD)
Encompasses spectrum of disorders arising from the placental trophoblast
Gestational trophoblastic neoplasia refers to persistent trophoblastic tissue presumed to be malignant
Recognized as most curable gynecologic malignancy
Key Points
Gynecologic disorders diminish quality of life for women and their families
Structural disorders of the uterus and vagina related to pelvic relaxation and urinary incontinence may be a result of delayed childbearing, but they are also seen in young or childless women
Key Points
Bladder training and pelvic muscle exercises significantly decrease or relieve mild to moderate urinary incontinence
Development of neoplasms can have significant physical and emotional effect on woman/family
Abnormal uterine bleeding is most common symptom of leiomyomas or fibroid tumors
Key Points
Various alternatives to hysterectomy exist for structural and benign disorders of the uterus - Women need to be informed about the risks and benefits
Endometrial cancer is the most common reproductive system malignancy
Hysterectomy is the usual treatment for early-stage endometrial cancer
Key Points
HPV is primary cause of cervical cancer and is linked to vulvar cancer in women younger than 40
Squamocolumnar junction is important landmark identified with neoplastic changes of the cervix
Preinvasive cancer of the cervix may be treated with electrosurgical excision, cryotherapy, and laser therapy to save the structure of the cervix
Key Points
Combination external and internal radiation therapy is successful in treating early stages of cancer of the cervix
Pap test detects about 90% of early cervical dysplasias
Cancer of the ovary causes more deaths than any other female genital tract cancer
Key Points
Control exposure to radiation in three ways
Increase distance from radiation source- Limit time of exposure, Use lead shielding, Cancer is relatively infrequent during pregnancy: 1:1000
Key Points
Radiation or chemotherapy treatment of the pregnant woman with cancer places fetus at risk for death, miscarriage, teratogenesis, growth and development alterations
Gestational trophoblastic neoplasms highly curable but require close monitoring of hCG levels
