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Benign gynaecological conditions (Ovarian tumours (clinical manifestation,…
Benign gynaecological conditions
Ovarian tumours
clinical manifestation
Asymptomatic - chance finding (eg, on bimanual examination or ultrasound).
Dull ache or pain in the lower abdomen, low back pain.
Torsion or rupture may lead to severe abdominal pain and fever.
Dyspareunia.
Swollen abdomen, with palpable mass arising out of the pelvis, which is dull to percussion and does not disappear if the bladder is emptied.
Pressure effects - eg, on the bladder, causing urinary frequency, or on venous return, causing varicose veins and leg oedema.
Torsion, infarction or haemorrhage:
risk factors
Older age.
Inherited gene mutations
Family history of ovarian cancer.
Estrogen hormone replacement therapy
Age when menstruation started and ended
pathophysiology
the cause is not known but the condition tends to run with families the risk is high in women with a history of premenopausal breast ovarian tumours that are hereditary has been traced to mutations in specific genes on chromosome 17,BRCA 1gene and chromosome13 BRCA2 gene this two genes are also implicated in breast cancer hence the the over-present danger of the two tumours occuring simultaneously
pharmacological management
hormonal suppression
oral contraceptives may be used for 2 onths
Olaparib (Lynparza) and rucaparib (Rubraca) are used to treat advanced ovarian tumour
therapeutic management
offer psychological care
provide emotional support
show care and empathy
Endometriosis
causes
heredity
retrograde menstruation.
polymenorrhoea
clinical manifestation
Abdominal cramps or back pain during menstruation
Severe menstrual cramps
Painful bowel movements or urination, especially during menstruation
Abnormal or heavy bleeding during periods
Painful sex
Difficulty becoming pregnant
pathophysiology
Endometriosis is defined as the presence of endometrial glands and stroma in ectopic locations, or locations other than the interior of the uterus. Primarily these locations are found to be the pelvic peritoneum, ovaries, and rectovaginal septum. Endometriosis is a chronic inflammatory, estrogen-dependent disease where ectopic implantations lead to an inflammatory reaction that may result in scar tissue
pharmacological management
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs should be administered several days before the start of menstruation in order to block the endometriosis-associated prostaglandin formation that leads to pain and swelling.
Combined Estrogen-Progestin Contraceptives: These drugs, which are available in pill, transdermal patch, and vaginal ring formulations, are considered an appropriate treatment option for the pain of endometriosis until pregnancy is desired.