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Benign Gynaecological conditions (Leiomyoma’s (uterine fibroids)…
Benign Gynaecological conditions
Ovarian tumours
Causes
unknown
Risk factors-
family inheritance
Pathophysiology
-
the condition tends to run in families; the risk is high in women with a history of premenopausal breast or ovarian cancer in first- or second-degree relatives
Clinical manifestation
-
metastasis, Premenopausal, irregular menses, urinary frequency, constipation, abdominal distension
Management
-
hormonal suppression with oral contraceptives for two months.signs are positive for ovarian cancer,exploratory laparotomy is recommended with radical hysterectomy.
Nursing care plan
:-
urinal catheter is drainin, increase circulation,relieve tension and muscle spasm, monitor vital signs, pack vagina with pad
Leiomyoma’s (uterine fibroids)
definition
Benign slow growing tumours in the myometrium
Causes
-
unknown
Risk factors
-
stimulation of normal hormonal function evidenced by accelerate growth during pregnancy and post menopausal
Pathophysiology
-.
single seedling grow slowly , cause pressure in pelvis. Abnormal bleeding during menstruation lead to anaemia and infertility
Clinical manifestation
-
heavy menstrual flow with dysmenorrhoea,stomach bloating, lower back pain, constipation, frequent urination and urgency
Management
medical- large tumours may be removed through Myomectomy- done vargianly, laparoscopic, abdominally. Administer oestrogen-free hormonal therapy.
Hysterectomy
Nursing care plan
- ,
urinal catheter draining, apply heat and relieve tension and muscle spasm, monitor vital signs, pack vagina with pads
Endometriosis
definition
characterised by the presence of endometrial tissue (comprising endometrial stroma and glands) outside the uterus
Causes
unknown
Risk factors
polymenorrhoa, female relative with endometriosis
Pathophysiology
menstrual effluent flows backward through the fallopian tubes into the pelvic cavity. Deposition of endometrial tissue on abdominal scars during laparotomies. rupture and heal to form scar tissue and extensive adhesions
Clinical manifestation
-
severe dysmenorrhoea reported, dyspareunia, chronic lower abdominal pain from the adhesions, infertility or subfertility.
Management
Prescribed analgesics, Oral contraceptives. Surgical treatment involves cauterisation or excision of the lesions where possible.
Nursing care plan
urinal catheter is draining, increase circulation,relieve tension and muscle spasm, monitor vital signs, pack vagina with pads
Vaginal fistulas
Causes
-
mechanical and chemical injuries
Risk factors
-
faeces leak into vargina, urine leak into vargina
Pathophysiology
-
varginal injuries may be penetrating and involve of anterior wall of the uterus and the bladder result in a vesico-vaginal fistula causing urine to leak constantly into the vagina, involving the posterior vaginal wall and the rectum may result in a recto-vaginal fistula
Clinical manifestation
-
Fistulae, such as vesico-vaginal and recto-vaginal fistulae, Cystocele or a rectocele
Management
-
Colporrhaphy,repair anterior wall, while perineorrhaphy,repair of the posterior vaginal wall.
Nursing care plan
-
relieving discomfort, preventing infection. personal hygiene, Provide effective deodorants to control the odour, Give vaginal douches to ensure cleanliness and promote comfort
Uterine prolapse
Causes
weak musculature supporting the uterus
Pathophysiology
-
musculature that supports the uterus becomes weak after childbirth. The uterus protrudes into the vargina pulling some of the virginal wall, bladder and the rectum
Clinical manifestation
discomfort, feeling of fullness and bearing down in the vargina, worse by coughing, urinary incontinence, constipation
Management
-
elevate the foot end to effect gravity, exercises. Surgical- suturing uterus back in place and strengthening the supporting muscles, repair cystocele or rectocele
Nursing care plan
-
keep cather insitu for 2-4 days,prescribed IV fluids given correctly, record fluid intake and output, observe sanitary pad for bleeding, ensure daily varginal douches with sterile warm saline.