Uterine Flashcards
What is dysfunctional uterine bleeding?
Any symptomatic variation from normal menstruation (regularity, frequency, volume and duration)
What are the 3 main causes of dysfunctional uterine bleeding and examples of each?
Intermenstrual - ectopic, hormonal, infection, polyps, fibroids, iatrogenic
Post coital - infection, ectropion, cancer, trauma
Breakthrough - oral contraception
What are the risk factors for dysfunctional uterine bleeding?
Extremes of reproductive age
PCOS
Endocrine disorders
Obesity
What are the signs and symptoms of dysfunctional uterine bleeding?
Menstrual irregularity Anemia Uterine bleeding Hirsutism Acne Acanthosis nigricans
What are the investigations completed to diagnose dysfunctional uterine bleeding?
Pregnancy test
STI test
Transvaginal ultrasound
Endometrial biopsy
What is the most common type of endometrial cancer?
Adenocarcinoma in the corpus mucosa
What are the risk factors for endometrial cancer?
Obesity >50 years old Endogenous oestrogen Tamoxifen Insulin resistance Family history PCOS Radiotherapy
What are the investigations to diagnose endometrial cancer?
Transvaginal ultrasound Endometrial biopsy Hysteroscopy PAP smear FBC MRI/CT
What is the management for endometrial cancer?
Surgery
Radiotherapy
Chemotherapy
Hormonal treatment
What is a uterine fibroid?
Benign tumors of the uterus composed of smooth muscle and fibrous connective tissue
What are the risk factors for fibroids?
Obesity
Black ethnicity
HTN
What are the signs and symptoms of fibroids?
Menorrhagia Irregular firm central pelvic mass Pelvic pain Bloating Urinary frequency, urgency and incontinence
What are the investigations done to diagnose a fibroid?
Ultrasound Endometrial biopsy Sonohysterography Hysteroscopy MRI Laparoscopy
What is the management for a fibroid?
GNRH agonists, Mifepristone, levonorgestrel IUD, NSAIDS
Myomectomy
Uterine artery embolisation
Hysterectomy
What is a uterine prolapse?
Loss of anatomical support for the uterus - can involve anterior and posterior vagina.
What are the causes of uterine prolapse?
Pregnancy
Hysterectomy
Joint hypermobility
Connective tissue disorders
What are the signs and symptoms of uterine prolapse?
Vaginal protrusion Vaginal pressure Urinary incontinence Constipation Lower back pain
What are the investigations to diagnose a prolapse?
Post Void Residual volume
Urinalysis
Urodynamics
What is the management for a prolapse?
Watchful waiting
Pessaries
Surgery
What are the causes of endometritis?
STDs TB Pregnancy Hysterectoscopy IUD
What are the risk factors for endometritis?
C section PROM Long labour Manual placental removal Severe meconium stained amniotic Extremes of maternal age
What are the signs and symptoms of endometritis?
Abdominal swelling Abnormal vaginal bleeding Constipation Fever Lower abdominal pain Dysuria
What are the investigations needed to diagnose endometritis?
Blood cultures
Endometrial biopsy
Laparoscopy
FBC, ESR, CRP
What is the management for endometritis?
Antibiotics, IV Fluids
Practise safe sex
Routine screening
What are the 2 main deformities of the uterus?
Bicornuate uterus
Uterus Didelphys
What is a bicornuate uterus?
A heart shaped uterus
What are the causes of a bicornuate uterus?
Congenital abnormality
What are the symptoms of a bicornuate uterus?
Irregular vaginal bleeding Repeated miscarriage Painful periods Abdominal discomfort Pain during intercourse
What are the investigations to diagnose a bicornuate uterus?
Ultrasound
MRI
Hysterosalpingogram
Pelvic exam
What is the treatment for a bicornuate uterus?
Strassman Meteroplasty
What is uterus didelphys?
A double uterus
What causes a double uterus?
Fusion of the mullerian ducts fails to happen - 2 uteri
What are the symptoms of a uterus didelphys?
Repeated miscarriage
Menstruation not stopped by tampon
What are the investigations to diagnose a double uterus?
Ultrasound
Sonohystogram
MRI
Hysterosalpingography
What is the treatment for a uterus didelphys?
Remove the wall between the 2 uteri
