Benign Gynaecological conditions

1. Benign condition
of the Ovaries, Uterus, Cervix
and
Endometrium
& Endometrial polyps
Dr Shazia Iqbal
Assistant Professor Obstetric and Gynecology
Vision College of Medicine in Riyadh

2. Benign condition of the Ovaries

3. Benign condition of the Ovaries
• Follicular cyst
• Corpus luteal cyst
• Theca luteal cyst
Functional
• Tubo-ovarian abcess
• Endometrioma
Inflamatory
• Benign teratoma (dermoid cyst)
Germ cell
• Serous cystadenoma
• Mucinous cystadenoma
• Brenner tumour
Epithelial
• Fibroma
• Thecoma
Sex cord stromal

4. Benign condition of the Ovaries
▪ common in reproductive ages
▪ Operation only when rupture and hemorrhage occurs
▪ Physiologic enlargement
– Functional cysts
– Hyperthecosis
– PCO
– Luteoma of pregnancy
• Ovarian neoplasms
- Epithelial tumors
- Sex cord stromal tumors
- Germ cell tumors

5. Follicular cysts
▪ Result from a failure of ovulation
▪ Typically asymptomatic
▪ May cause pain, dyspareunia, bleeding and torsion
▪ Disappear within 60 days
Functional cysts

6. Polycystic Ovary Syndrome (PCOS)
▪ most common endocrine disorder in women of reproductive age
▪ main features of PCOS :
Irregular periods
Hyperandrogenism
polycystic ovaries

8. PCOS cont..
Sign & Symptoms
▪ irregular periods
▪ Hirsutism
▪ weight gain
▪ Acne
▪ Pelvic pain

9. Epithelial Tumors
Serous cystadenoma
▪ 25-30% of epithelial tumors
▪ 5-15 cm, sometimes bigger
▪ Age 20s-50s
▪ usually unilocular
▪ NO nuclear atypia
▪ Psammoma bodies (concentric calcifications) in 15%
▪ Tumor marker Ca125
Ovarian Neoplasms

11. Mucinous cystadenoma
It is benign cystic tumor lined by a mucinous epithelium
▪ 10-20% of epithelial tumors
▪ Age 30s-50s
▪ largest tumors in the body up to 50 cm
▪ Usually multilocular
▪ can extend up into the abdomen.
▪ Tumor marker Ca19-9
Epithelial Tumors
Ovarian Neoplasms

13. Germ Cell Tumors
▪ %20 of all ovarian tumors
▪ Usually in children and young women
▪ %50-60 of all tumors seen under age 20
▪ Cystic teratoma is %95 of all benign germ cell tumors
Ovarian Neoplasms

14. ▪ Teratomas (DERMOID CYSTS)
▪ Usually unilocular
▪ Most common tissue is neuronal tissue
▪ Filled with yellowish colored fluid with hair, tooth and bones in it
▪ Complications
– Torsion ( the most)- usually in children and women
– Rupture ( very rare)
– Infection
– Malignant transformation
Germ Cell Tumors
Ovarian Neoplasms

16. Benign condition of the Uterus
& endometrium

17. Benign condition of the Uterus &
endometrium
▪ Congenital Anomalies ( Mullerian fusion anomalies)
▪ Leiomyoma
▪ Adenomyosis
▪ Endometrial Polyps
▪ Endometritis
▪ Asherman Syndrome

18. Congenital Anomalies
▪ Incomplete Mullerian Fusion
– Uterine didelphys ( 2 separate uterine horns)

19. Congenital Anomalies
▪ Incomplete Mullerian Fusion
– Bicornuate uterus ( due to partial incomplete fusion)

20. Congenital Anomalies
▪ Incomplete Mullerian Fusion
– Unicornuate uterus

21. Congenital Anomalies
▪ Incomplete Mullerian Fusion
– Arcuate uterus

22. women with Mullerian defects has
Risk factor for renal abnormalities 20-30%

23. Leiomyoma (uterine Fibroids)
It is a benign neoplasm arising from smooth muscle cells in the
uterine wall
▪ Symptoms
▪ Usually asymptomatic
▪ Metrorrhagia (irregular bleeding)
▪ Menorrhagia (heavy uterine bleeding )
▪ Pain
▪ İnfertility

24. ▪ Type :
1. Submucous
2. Intramural or interstitial
3. Subserous

25. Treatment
– Medical therapy
▪ GnRHa
▪ OC
▪ Levonorgestrel releasing intrauterine device
– Surgery
▪ Myomectomy
▪ Hysterectomy
▪ Uterine fibroid embolisation

26. Adenomyosis
▪ It is a presence of endometrial glands and stroma within the
myometrium
▪ Can be diffuse or localised
▪ Symptoms
– Menorrhagia
– Dysmenorrhea
▪ Treatment
– Hysterectomy
– GnRHa

27. Endometrial Polyps
▪ Is hyperplastic growth of the endometrium
▪ Risk factors
– Hypertention
– Obesity
– Tamoxifen therapy (block the effects of estrogen)

29. Endometritis
▪ Symptoms
– Uterine tenderness
– Fever
– Foul smelling discharge
Risk factor
– Hysteroscopy
– dilation and curettage (uterine scraping)
– Placement of IUD
Treatment
- Antibiotic

30. Asherman Syndrome
▪ is a rare, acquired condition of the uterus after scar tissue or
adhesions due to recurrent D&C
Symptom
▪ Secondary amenorrhea
▪ infertility
▪ hypomenorrhea

31. Treatment
▪ By surgery ( hysteroscopy)

32. Add a Slide Title - 5

33. Benign condition of cervix

34. Benign condition of cervix
▪ Congenital Anomalies
– Cervical agenesis
– İncomplete Mullerian fusion
– Failure of resorption
▪ Cervical Injuries
– Laserations
– Perforations
– Ulcerations
– Cervical stenosis
▪ Cystic Abnormalities
– Nabothian cyts
▪ Cervical Stenosis
▪ Benign Neoplasms
– cervical polyps
– papillomas
– leiomyomas

35. Cervical Infections
▪ Acute Cervicitis
▪ Chronic Cervicitis
– Chlamydia trachomatis
– N. gonorrhea
– HSV (Herpes simplex viruses)
– HPV (Human papillomavirus )
– Trichomonas vaginalis
– Candidia
– Bacterial vaginosis

36. Cervical Infections
▪ Complications
– Cervical hemorrhage
– Salpingitis (inflammation of the fallopian tubes)
– Leukorrhea ( discharge from the vagina)
– Cervical stenosis
– Infertility

37. Cervical polyp
▪ It is a benign tumours arising from the endocervical epithelium
▪ smooth, reddish and protrusions diagnosed incidentally during a
routine cervical smear
▪ Usually Asymptomatic
▪ Easily removed by avulsion with polyp forceps

39. Refrance
▪ https://www.amboss.com/us/knowledg
e/Hormonal_contraceptives
▪ Oxford Handbook of Obstetrics and
Gynecology 3rd Edition
▪ https://step2.medbullets.com/gynecolo
gy/120201/contraception

40. Thank you