Podcast
Questions and Answers
What is a common clinical manifestation of submucous myoma?
What is a common clinical manifestation of submucous myoma?
Why do serous and subserous myoma not cause abnormal uterine bleeding (AUB)?
Why do serous and subserous myoma not cause abnormal uterine bleeding (AUB)?
What is a characteristic of intramyoma that can cause heavy bleeding?
What is a characteristic of intramyoma that can cause heavy bleeding?
What is the main difference between submucous and serous myoma?
What is the main difference between submucous and serous myoma?
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What is the effect of submucous myoma on the uterus?
What is the effect of submucous myoma on the uterus?
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What is the primary cause of abnormal uterine bleeding (AUB) in patients with myoma?
What is the primary cause of abnormal uterine bleeding (AUB) in patients with myoma?
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What is a common characteristic of heavy menstrual bleeding in patients with myoma?
What is a common characteristic of heavy menstrual bleeding in patients with myoma?
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What is the effect of intramyoma on menstrual bleeding?
What is the effect of intramyoma on menstrual bleeding?
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What is the estimated percentage of gynecologic patients that have cervical polyps?
What is the estimated percentage of gynecologic patients that have cervical polyps?
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In which age group are endocervical polyps most common?
In which age group are endocervical polyps most common?
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What is a common symptom of cervical polyps?
What is a common symptom of cervical polyps?
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What is the etiology of cervical polyps?
What is the etiology of cervical polyps?
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What should be ruled out when investigating cervical polyps?
What should be ruled out when investigating cervical polyps?
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What is the examination method used to describe the cervix?
What is the examination method used to describe the cervix?
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Study Notes
Urology and Gynecology
- Foley Catheter is usually left in place for 48-72 hours to prevent urinary retention and avoid stenosis.
- Follow-up requires observing for development of urethral stenosis and recurrence.
Female Reproductive System
- The vestibule has six openings: two Skene's glands, two Bartholin's glands, vaginal introitus, urethral opening, and hymen.
- Caruncle myrtiformes are remnants of the adult female.
- Periurethral/Skene's glands and Vulvovaginal/Bartholin's glands are glandular structures.
Hormones
- Progesterone: critical mitogen, responsible for growth control, and maintains progesterone receptors.
- Estrogen: upregulates and maintains progesterone receptors, permits cellular proliferation, ECM accumulation, and cellular hypertrophy.
Myoma
- Characterized by extensive coagulative necrosis, carneous or red degeneration, and can cause severe pain and peritoneal irritation.
- Occurs in 5-10% of pregnant women, especially in those with a history of leiomyoma.
- Can be treated with GnRH agonists to shrink the myoma to 40-50% before surgery.
Cervical Stenosis
- Most often affects the internal os.
- Can be congenital or acquired, often seen in patients with a history of cervical biopsy, LEEP, or cone biopsy.
- Treatment involves dilation of the cervix.
Endometrial Polyp
- Localized overgrowth of endometrial glands and stroma that project beyond the endometrial surface.
- Soft and pliable, single or multiple, ranging from a few mm to several cm, and may be broad-based or have a slender pedicle.
- Associated with endometrial hyperplasia and unopposed estrogen.
- Incidence: more common in women aged 40-49 years old.
- Malignancy is related to the patient's age and is often of a low stage and grade.
Cervical Laceration
- Presents with vaginal bleeding, dysuria, urgency, obstruction, and dyspareunia
- Diagnosis through speculum, pelvic examination, and biopsy
- Management: hemostasis and ligation of bleeders, GnRH agonists, excision, or hysterectomy depending on reproductive status
Hemostasis and Ligation of Bleeders
- Major arterial supply to the cervix is located on the lateral cervical walls at the 3 and 9 o'clock positions
- Deep figure-of-eight suture through the vaginal mucosa and cervical stroma at 3 and 9 o'clock helps reduce blood loss during procedures like cone biopsy
Cervical Polyps
- Most common benign neoplastic growths of the cervix (4% of gynecologic patients)
- Endocervical polyps are most common in multiparous women in their 40's and 50's
- Etiopathogenesis: abnormal focal responsiveness (hyperplasia and proliferation) to hormonal stimulation or local inflammation
- Characteristics: fragile, bleed easily when touched, usually asymptomatic, but may present with abnormal bleeding
- Diagnosis: speculum examination and biopsy
- 6 subtypes: adenomatous (80%), cystic, fibrous, and others
Cervical Stenosis
- Causes: operative, fragile, and bleed easily when touched
- May present with abnormal bleeding: postcoital bleeding, menorrhagia, postmenopausal bleeding
- Ulceration is rare (less than 1 in 200)
Nabothian Cyst
- A small mucous polyp at the external os, typically cherry red
- May be diagnosed through speculum examination and can be confirmed through visualization
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Description
Learn about the use of Foley catheters in preventing urinary retention and urethral stenosis, as well as the importance of follow-up care. Understand the risks and complications associated with this procedure.
