Tubal disease

Question 1

Give 3 infective causes of tubal disease?

Answer 1

• Pelvic inflammatory disease
• Transperitoneal spread
• Following procedure (IUCD insertion, hysteroscopy, HSG)

Question 2

Give at least 3 non-infective causes of tubal disease?

Answer 2

• Endometriosis
• Surgical (sterilisation, ectopic)
• Fibroids
• Polyps
• Congenital
• Salpingitis isthmica nodosa

Question 3

Give the classic clinical features of pelvic inflammatory disease?

Answer 3

Abdominal / pelvic pain
Vaginal discharge
Dyspareunia
Cervical excitation
Menorrhagia
Dysmenorrhoea
Infertility
Ectopic pregnancies

Question 4

Give the definition of endometriosis?

Answer 4

The presence of endometrial glands outside of the uterine cavity

Question 5

What is the most likely cause of endometriosis?

What are some other causes?

Answer 5

Retrograde menstruation

Others: altered immune function, abnormal cellular adhesion molecules, genetic causes

Question 6

Give the classic clinical features of endometriosis?

Answer 6

Dysmenorrhoea
Dyspareunia
Menorrhagia
Painful defecation
Chronic pelvic pain
‘chocolate’ cysts on ovary USS
Infertility
Fixed and retroverted uterus (in some cases)