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DIFFERENTIAL DIAGNOSIS OF COMMON GYNECOLOGICAL COMPLAINTS . . . CONT.

Notes

retroverted, retroflexed uterus may cause dyspareunia ovarian cysts/tumours symptomatic retroverted uterus psychological trauma vaginismus vulvodynia

PELVIC PAIN

Acute Pelvic Pain gynecological causes • ectopic pregnancy • abortion - missed, septic, etc... • ruptured ovarian cyst • torsion of ovary or tube • hemorrhage into ovarian cyst, neoplasm • degeneration of fibroid • torsion of pedunculated fibroid • acute PID • mittelschmertz (ovulation pain as follicle ruptures into peritoneal space) non-gynecological causes • appendicitis • UTI - cystitis, pyelonephritis • renal colic • mesenteric adenitis • diverticulitis • inflammatory bowel disease

Chronic Pelvic Pain refers to pain of greater than 6 months duration gynecological causes of CPP • chronic PID • endometriosis • adenomyosis • invasive cervical ca (late) • leiomyomata • uterine prolapse • adhesions • cyclic pelvic pain • primary dysmenorrhea • secondary dysmenorrhea • ovarian remnant syndrome • pelvic congestion syndrome • ovarian cyst non-gynecological causes • referred pain • urinary retention • urethral syndrome • penetrating neoplasms of GI tract • irritable bowel syndrome • partial bowel obstruction • inflammatory bowel disease • diverticulitis • hernia formation • nerve entrapment • constipation • psychological trauma • 20% of CPP is due to history of previous sexual abuse/assault

Gynecology 6

MCCQE 2000 Review Notes and Lecture Series

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