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gynecology_1.1_fibroid (v hormonal (combined oral contraceptive, oral…
gynecology_1.1_fibroid
investigations
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endometrial sampling (pipelle), hysteroscopy
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physical examination
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vaginal
speculum, bimanual examination
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surgical
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myomectomy FIRBOID: recurrence SURGERY: uncontrolled bleeding hysterectomy, adhesion tubal patency FUTURE PREGNANCY: 6 months later, Caesarian section, uterine rupture
how to choose
v symptoms
x fertility
hysterectomy (GnRH analogue: increase Hb, decrease fibroid) symptoms
v fertility
myomectomy (GnRH analogue: increase Hb, decrease fibroid) symptoms
x symptoms
v fertility
v cavity distorsion
myomectomy (GnRH analogue: increase Hb, decrease fibroid) symptoms
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definition
hormone-dependent
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pregnancy (pain/red degeneration of fibroid), malpresentation if lower pole
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differential diagnosis
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structural
myometrium
(intramural, submucosal) fibroid, adenomyosis
endometrium
cancer/hyperplasia, polyp, endometritis
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functional
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Cushing's disease, hypothroidism
anticoagulant, coagulopathy (von Willebrand disease), ITP
(normal uterus: 3 inches tall, 2 inches wide, 1 inch thick)
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