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GYNECOLOGICAL ONCOLOGY . . . CONT.

Notes

UTERUS

Benign Uterine Lesions

Leiomyomas (fibroids) (see Colour Atlas D5) epidemiology • 20% of women > 35 years • more common in black women • most common indication for major surgery in females pathogenesis • arise from smooth muscle • estrogen-dependent benign tumour • degenerative changes include • red degeneration • hyaline degeneration • cystic degeneration • fatty degeneration • calcification • sarcomatous degeneration clinical presentation • general symptoms • asymptomatic • abdominal swelling • pelvic pain, pressure and/or heaviness • menorrhagia • abnormal bleeding pattern • difficulty voiding, defecating • locations (see Figure 10) • intramural • initial growth commences in myometrium • abdominal swelling • menorrhagia • infertility • submucosal (most symptomatic) • further extension of growth inwards, into uterine cavity • menorrhagia is common • dysmenorrhea • infertility • recurrent abortions

• subseroscaaln be pedunculated (on a stalk) e x t e n s i o n o f g r o w t h o u t w a r d s a s y m p t o m a t i c u n l e s s l a r g e c a n b e p e d e n c u l a t e d t o r s i o n m a y o c c u r c e r v i c a l • rare e a r l y p r e s s u r e e f f e c t s i n r e g i o n o f b l a d d e r n e c k b l e e d i n g i n f e c t i o n d y s p a r e u n i a i n f e r t i l i t y e x t r a u t e r i n e

Gynecology 42

MCCQE 2000 Review Notes and Lecture Series

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