Cysts and fibroids

This presentation Cysts and fibroid is very precise and easy topic to learn and understand

1. CYSTS AND FIBROIDS

2. DEFINITION A uterine fibroid is a [non cancerous] tumor that originates from the smooth muscle layer and the accompanying connective tissue of the uterus. Fibroids develop with the uterine wall or attach to it . They may grow as a single tumor o r in clusters.

3. ETIOLOGY Etiology is not clear. Chromosomal abnormality. Reasons for occurrence of the fibroids. Epidermal growth factor.

4. TYPES Interstitial or Intramural Fibroids : These are the most common type and are located within the wall of the uterus Subperitoneal or Subserosal fibroids :these are located underneath the mucosal surface of the uterus and can become very large Sub mucosal Fibroids : these are located in the muscle beneath the endometrium of the uterus Cervical Fibroids : these are rare ,fibroids are located in the wall of the cervix ( neck of the uterus ) depending upon position it my be anterior posterior lateral or central

5. CLINICAL FEATURES They grow slowly Fibroids may be single or multiple menstrual abnormalities such as menorrhagia or metrorrhagia Dysmenorrhoea associated with pelvic congestion or endometriosis Abnormal gynecologic hemorrhage heavy or painful periods abnormal discomfort or bloating Menstrual bleeding pelvic pain and frequent urination Pain during intercourse depending on the location of the fibroids Infertility can be a major completed Defecation backache Painful urinary frequency or retention During pregnancy case of miscarriage bleeding premature labor Pressure on the rectum resulting in constipation Pelvic pressure feeling full in the lower abdomen lower abdominal pain Pressure on the bladder

6. MANAGEMENT EXPECTANT MANAGEMENT Expectant management is followed in the cases where fibroid is asymptomatic Lesion can be managed expectantly depending on the symptomatology and presence of related condition Thus most cases of fibroids are managed by watchful waiting which include periodic sonographic assessment. MEDICAL MANAGEMENT Drug therapy is mainly given to minimize blood loss as there is a lot of blood loss due to excessive vaginal bleeding Progesterone such as norethistrone acetate or medroxyprogestrone acetate is administered periodically from day 5 of the cycle for 20 days. Prostaglandin synthetase inhibitors are given to receive pain Antifibronylitics such as tranexamic acis is given to reduce blood loss Danazole can minimize the volume of the fibroids slightly

7. SURGERY Hysterectomy or myomectomy in which only the fibroids is removed Myomectomy Hysterectomy Laproscopy Hysterectomy

8. OVARIAN CYST DEF:- collection of fluid surround by a very thin wall within an ovary an ovarian cyst can very in size as it can be small as per larger then an orange Ovarian cyst affect women of all ages Ovarian cyst can be functional non neoplastic or benign cyst

9. FUNCTIONAL CYST An functional cyst are not related with any disease these type cyst occur during ovulation and are part of the normal process of the menstruation the cyst can be treated FOLICULAR CYST OF OVARY it is the commonest functional cyst it can be due to more secretion of oestrogen LUTEAN CYST These cyst are usually caused due to excessive secretion of chorionic gonadotrophin hormone These are mostly bilateral

10. NON FUNTIONAL CYST Deroid cyst :- In around 15-20 % it is a bilateral tumor Teeth and bones are found in this area Mucinous cyst adenoma :- bilateral tumor is found in around 10% of total cases. It accounts for around 20-25% of all ovarian tumors if not treated it can be of a big size it is the largest benign ovarian tumor. Serous cyst adenoma:- this tumor accounts for about 40% of all tumors it can be bilateral in around 40% cases it is of smaller size as compared to mucinous cyst.

11. SIGN AND SYMPTOMS Mostly the tumor is asymptomaties defected accidentally Dull aching or severe swelling and sharp pain the lower abdomen Fullness pressure swelling or bloating in the abdomen Heaviness in the lower abdomen Breast tenderness pitting edema of legs Irregular periods or abnormal uterine bleeding or spotting Weight gain Nausea and vomiting Headache Fatigue Infertility On palpation it freely mobile from side to side but restricted from above down On bimanual examination a grow can be felt between the uterus and the mass The lower pole of the cyst can be felt through the fornix

12. INVESTIGATION Sonography Abdominal x-ray Laproscopy Cystology and laparotomy DIAGNOSIS - Ovarian cyst usually diagnosed by either ultrasound and CT scan

13. TREATMENT Treatment for cyst depends on the size cyst and symptoms Most of the cyst are benign in nature To minimize complication surgery may be indicated In young ovarian lystectomy is performed leaving behind the healthy ovarian tissue For big tumors ovariotomy is performed Total hysterectomy bilateral salpingo ophorectomy is done in the parous women above 40% pain caused by ovarian cyst may be treated with pain relievers A heating pad or hot water bottle applied to the lower abdominal near the ovarious can relaxed tones muscles and lesion discomfort and stimulate circulation and healing in then ovaries In every case the tumor must sent for histological examination