A Simple Guide to Uterine Fibroids

A Simple Guide to Uterine Fibroids
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What are Uterine Fibroids ?
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Uterine Fibroids are solid benign tumours(non-cancerous) of the smooth muscles and fibrous tissues of the uterine cavity.

The name fibroid is derived by the fibrous tissue present in the tumour.

They are the commonest tumours (25%)found in women especially after the age of 35.

What are the different types of Uterine Fibroids?
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They are classified according to their location.

1.intramurally(inside the cavity of the uterus(70%)

2.subserous(on the outer wall of the uterus) on the external wall(20%)

3.Submucous (in the lining of the uterus) 10%

4.pendunculated subserous(like a polyp outside the uterus)

5.cervical(at the cervix or beginning of the uterus)

What are the Causes of Uterine Fibroids?
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The cause of Uterine Fibroids is still not known.

It is believed that oestrogen has a part to play in the formation since fibroids are not present before puberty and sometimes shrinks after menopause.

Generally it is believed that during the thickening and shedding of the endometrium of the menstrual cycle, some uterine muscles and connective tive tissues overgrow and form a swelling in the wall of the uterus.

Fibroids are generally relatively avascular and may degenerate forming cysts and becoming calcified.

What are the Symptoms of Uterine Fibroids?
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Most women with fibroids are asysptomatic.

Symptoms and signs varies with the size and location of the fibroid.

Common symptoms include:

1.Heavy menstrual flow sometimes with blood clots

2.Irregular menstrual periods

3.Painful menses

4.Backache

5.Painful and frequent urination

6.Bloating

7.Constipation

8.Fatigue

Signs:
1.Enlarged uterine mass on abdominal palpation

2.Anaemia and pallour due to blood loss

How do you made the Diagnosis of Uterine Fibroids?
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Pelvic examination may show enlarged uterine swellings

Ultrasound scan showed presence of fibroids

Colposcopy may show the location of the fibroid.

What are the complications of Uterine Fibroids?
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1.sarcoma

2.degeneration

3.necrobiosis

4.cystic degeneration

5.torsion of pendunculated fibroid

What is the Treatment for Uterine Fibroids?
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If small no treatment is required.

If larger,then treatment depends on the
1.size,
2.extent of the lesions,
3.age of the patient and
4.the desire for pregnancy.

Surgery
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is required if
1.extremely heavy bleeding occurs during the menstrual cycle

2.anemia follows heavy menses

3.pain has become intolerable

4.discomfort due to the pressure of the fibroids on another organ

a.Myomectomy is the surgical removal of the fibroid without damage to the uterus thus allowing a woman to be pregnant.
However recurrence of fibroids is quite common after myomectomy

b.Hysterectomy is preferred for fibroid tumors

1.when a women has severe symptoms,

2.has completed her family

3.excessively large fibroid tumors;

4.severe abnormal bleeding is present

5.fibroids are causing problems with the bladder and bowels.

Non surgical treatment:
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a.uterine artery embalization is a non-surgical procedure.
Polyvinyl particles are allowed to flow into the uterine artery and clog the nexis of vessels spread out into the uterine tissue.
The fibroids are unable to receive the constant blood supply and thus shrink over time.

b.Lupron is a drug which shrinks fibroids in most women.
Unfortunately the fibroids will grow back when Lupron treatment is stopped.

A Simple Guide to Salpingitis

A Simple Guide to Salpingitis
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What is Salpingitis?
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Salpingitis is an acute or chronic infection of the fallopian tubes in females.

What are the causes of Salpingitis?
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Acute Salpingitis is usually caused by the following:

Infections:
1.sexually transmitted disease like gonorrhea,trichomonas and chlamydia.

2.tuberculosis salpingitis is rare

3.Infection may follow chilbirth or abortion

Mechanical irritants:
intrauterine device may cause acute or chronic Salpingitis

What are the symptoms and signs of Salpingitis?
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Persons who has Acute Salpingitis has the following
Symptoms:

1.severe lower abdominal pain

2.purulent vaginal discharge

3.painful or frequency of urination

4.fever

Signs:
1.tenderness in either lower abdominal quadrant

2.discharge can be seen in female vagina

3.vaginal examination - lateral movement of cervix causes pain
- palpation of the fallopian tubes may be very painful

How do you diagnose Salpingitis?
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Diagnosis can usually be made by :
1.History of lower abdominal pain with vaginal discharge

2.Tenderness in lower abdominal region with occasional palpation of tender mass
in the fallopian tube region

3.vaginal examination for tenderness in the tubes region

4.swab to culture for bacteria and sexually transmitted organisms and the antibiotic most appropriate for it.

5.Full blood count

6. endoscopy to examine the fallopian tubes

What are thae complications of Salpingitis?
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Acute Salpingitis may progress to chronic Salpingitis:

1. tubal infection with abscess formation(pyosalphinx) or cyst formation(hydrosalphinx)

2. Pelvic abscess

3. Ovarian infection

4.Infertility due to tube blockage

5. Peritonitis may occur with rupture of cyst and abscess

What is the treatment of Salpingitis?
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1.Approprate Antibiotics for infections especially after uterine bacterial culture

2.Bedrest

3.Surgery may be necessary in cases not responding to antibiotics.
Drainage of the abscess may be done and infected tube resected if necessary

What is the prognosis of Salpingitis?
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Prognosis is usually good with current antibiotics and medication.

Sexual partner may need to be treated.

Recurrence is quite common.

Infertilty may result in blocked or scarred fallopian tubes