Benign diseases of the female sexual organs Prepared
Benign diseases of the female sexual organs. Prepared by N. Bahniy
Benign tumors of vulva
Papilloma
Bartholin's gland cyst
Lipoma
Fibroma
Hydradenoma
Gaertner cyst of the vaginadysontogenetic
Vaginal Polyp • This is a rare tumor which can be seen in infants or in adults. The origin from the vaginal mucosa has to be demonstrated to differentiate from much more common urethral caruncles, cervical and uterus polyps.
Vaginal fibroma • Fibroma of the vagina is a very rare tumor. It may be pedunculated and appear at the introitus. Clinically it is a firm benign noninfiltrating growth.
Cervix
Benign cervical lesions • • • Cervical erosion Leukoplakia (without atypia) Polyps Endometriosis Ectropion, scars • Exo-, endocervicites Algorithm for investigation • Speculum exam • Pap smear, bacterioscopy • Visual inspection after application acetic solution • Colposcopy • Biopsy
Cervical erosion • A true ulcer with loss of epithelial covering is seen in the anterior lip of cervix
Ectropion
Cervical polyp
Fibroma of the cervix
Cervical endometriosis
UTERUS
Uterine leyomyoma (fibromyoma) • Nodular • Multiple
• Laparoscopic view of a uterus with a pedunculated posterior myoma • A fibroid in this location should not affect chances for pregnancy or miscarriage • However, if it were pushing into the cavity of the uterus, it might cause problems
Protruded myoma Treatment of women with uterine leiomyomas must be individualized, based on: Symptoms, Size and Rate of growth of the uterus, and The woman’s desire for fertility.
Indications for surgical treatment - a rapidly growing myoma - persistent abnormal bleeding - Symptomatic myoma: pain or pressure - Myoma sizes more than 12 week of gestation Operations: myomectomy or hysterectomy
Treatment of women with uterine leiomyomas must be individualized, based on: 1. Symptoms, 2. Size and 3. Rate of growth of the uterus, and 4. The woman’s desire for fertility.
EMA – embolization of uterine artery
Hysteroscopy in submucous myoma
Submucous myoma
Conservative treatment • Gonadotropin-Releasing Hormone Agonists - should be restricted to a 3 - to 6 -month interval, following which regrowth of fibroids usually occurs within 12 weeks. • estrogen–progestin combinations • Gestagens (depot medroxy- progesterone acetate (Depo. Provera), IUD - MIRENA • Danazol has been associated with a reduction in volume of the fibroid in the order of 20% to 25%.
Ovary
Ovarian cysts Dermoid Thin membrane, small sizes, conservative or surgery, rare complications Conservative or Surgery: oophorectomy, ovarian resection Chocolate cyst
Ovarian cystomas Serous Cystadenoma Thick membrane, large sizes, surgery, most often complications Bilateral cystadenoma Papillary cystadenoma
Torsion of the ovarian pedicle mesosalpinx Surgical pedicle: • Ovarian lig • ov. Suspensory lig. • Mesosalpinx • Fallopian tube Anatomical pedicle: • Ovarian lig • ov. Suspensory lig. • mesosalpinx Surgery salpingooophorectomy
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