Benign Disorders of Reproductive Tract Flashcards Preview

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Flashcards in Benign Disorders of Reproductive Tract Deck (62)
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1
Q

Pelvic Organ Prolapse (POP)

A

the abnormal decent or herniation of the pelvic organs from their original attachment sites or normal position in the pelvis

2
Q

Pelvic Support Disorders

A

Pelvic organ prolapse
Urinary and Fecal Incontinence
-cause significant physical and psychological morbidity

3
Q

What causes pelvic support disorders?

A

weakening of the connective tissue and muscular support of pelvic organs due to a number of factors:

  • vaginal childbirth
  • age
  • heavy work
  • poor nutrition
  • increasing body mass
4
Q

What are the 4 types of Pelvic Organ Prolapse?

A
  • Cystocele
  • Rectocele
  • Enterocele
  • Uterine Prolapse
5
Q

Cystocele

A

occurs when the posterior bladder wall protrudes downward through the anterior vaginal wall

6
Q

Rectocele

A

occurs when the rectum sags and pushes against or into the posterior vaginal wall

7
Q

Enterocele

A

when the small intestine bulges through the posterior vaginal wall (straining)

8
Q

Uterine prolapse

A

the uterus descends through the pelvic floor and into the vaginal canal

9
Q

Stages of Pelvic Organ Prolapse

A

Stages 0-4

10
Q

Stage 0

A

NO descent of pelvic structure during straining

11
Q

Stage 1

A

prolapsed descending organ is > 1 cm above the hymenal ring

12
Q

Stage 2

A

prolapsed organ extends 1 cm below the hymenal ring

13
Q

Stage 3

A

prolapsed organ extends 2-3 cm below the hymenal ring

14
Q

Stage 4

A

the vagina is completely everted or the prolapsed organ is > 3 cm below the hymenal ring

15
Q

Risk factors for Pelvic Organ Prolapse

A
  • constant downward gravity
  • atrophy of supporting tissues b/c aging
  • childbirth trauma
  • reproductive surgery (hysterectomy)
  • family history
  • young age at first birth
  • connective tissue disorders
  • straining
  • obesity
16
Q

Symptoms of Pelvic Organ Prolapse

A
  • feeling of dragging, a lump in the vagina, or something “coming down”
  • vaginal bulging
  • pelvic pressure
  • difficulty defecating
  • stress/urge incontinence
17
Q

Therapeutic Management for POP

A
  • Kegel exercises
  • Hormone replacement therapy
  • Dietary and lifestyle modifications
  • Pessaries Colpexin Sphere
  • Surgery
18
Q

Vaginal Pessaries

A

synthetic devices inserted into the vagina to provide support to the bladder and other pelvic organs as a corrective measure

19
Q

What type of individuals would be recommended to use Pessaries rather than surgery?

A
  • Elderly clients
  • Woman who wish to have more children
  • Woman who prefer it over surgery
20
Q

Surgical Options for POP

A
  • Anterior or posterior colporrhaphy (cystocele/rectocele)

- Vaginal Hysterectomy (uterine)

21
Q

What to look for on physical examination for POP

A

Pelvic exam for any obvious protrusions and bladder function

22
Q

Diagnostic tests for POP

A

urinalysis, ultrasound, urine culture, postvoid urine volume

23
Q

What are the most common types of urinary incontinence?

A

Urge, stressed, and mixed

24
Q

Management of Urge Incontinence

A
  • Kegel exercises
  • Pessary ring
  • Pharmacotherapy-Anticholinergics
  • Surgery if all else fails
25
Q

Management of Stress Incontinence

A
  • weight loss
  • smoking cessation
  • avoid constipation
  • Kegel exercises
  • Meds-Duloxetine
  • Estrogen replacement therapy
  • Pessaries, weighted vaginal cones
  • surgery
26
Q

Most Common Benign Growths

A
Polyps 
Fibroids 
Cysts 
Fistulas
Bartholin cysts
27
Q

Cervical Polyps

A

small benign growths; frequently result from infection

-grayish white

28
Q

Where are Polyps most commonly found?

A

Cervix and uterus

29
Q

When do cervical polyps typically appear?

A

After menstruation

30
Q

What are the three types of polyps?

A

Cervical Polyps , Endocervical polyps and Endometrial polyps

31
Q

Endocervical Polyps

A
  • multiparous women age 40 to 60

- cherry red

32
Q

Endometrial Polyps

A

benign tumors or localized over growths of the endometrium

-rare in women under 20; peak in fifth decade; and decline after menopause

33
Q

Symptoms of Polyps

A

Usually asymptomatic

abnormal vaginal bleeding or discharge

34
Q

Nursing Management for Polyps

A
  • explanation of condition
  • rationale for removal
  • follow-up care instructions
35
Q

Uterine Fibroids

A

“Leimyomas”

benign tumors composed of smooth muscle and fibrous connective tissue in the uterus

36
Q

When do Uterine fibroids experience rapid growth and when do they shrink?

A

Rapid growth during childbearing years due to estrogen dependency and will shrink during menopause

37
Q

What are the three classifications of uterine fibroids?

A

Subserosol fibroids, Intramural fibroids, and Submucosal fibroids

38
Q

Subserosol Fibroids

A

lie underneath the outermost peritoneal layer of the uterus and grow outside the uterus; attached to uterus by a stalk or peduncle

39
Q

Intramural Fibroids

A

grow within the wall of the uterus and are the most common

40
Q

Submucosal Fibroids

A

grow immediately below the inner uterine surface (endometrium) into the uterine cavity

41
Q

Predisposing factors for Fibroids

A
  • age
  • genetic predisposition
  • African American ethnicity
  • Hypertension
  • Nulliparity
  • Obesity
42
Q

Medical Management for Fibroids

A

GnRH agonists
Progestin agonists
Uterine artery embolization

43
Q

Surgical Management of Fibroids

A

Myomectomy
Laser surgery
Hysterectomy

44
Q

Myomectomy

A

removing the fibroid alone; for women who still want to have children

45
Q

Laser Surgery

A

destroying small fibroids with lasers

46
Q

Hysterectomy

A

the surgical removal of the uterus

47
Q

Symptoms of Fibroids

A

chronic pelvic pain, low back pain, anemia, bloating, constipation, infertility, dysmenorrhea, miscarriage, sciatica, dyspareunia, urinary frequency/incontinence, menorrhagia, feeling of heaviness

48
Q

What are the 3 most common types of fistulas?

A
  • Vesicovaginal
  • Urethrovaginal
  • Rectovaginal
49
Q

Vesicovaginal Fistula

A

communication between the bladder and genital tract

50
Q

Urethrovaginal Fistula

A

communication between the urethra and the vagina

51
Q

Rectovaginal Fistula

A

communication between the rectum and the vagina

52
Q

Managing small fistulas

A

heal without treatment

53
Q

Managing large fistulas

A

will require surgical repair

54
Q

Fistula Symptoms

A

urine leakage, flatus leakage, discomfort

55
Q

Bartholin Cysts

A

swollen, fluid-filled, sac-like structure that results when one of the ducts of the Bartholin gland becomes blocked

56
Q

What can happen because of a Bartholin cyst?

A

infection and an abscess may develop

57
Q

Management of Bartholin Cysts

A
  • may heal on their own
  • sitz baths and analgesics for discomfort
  • antibiotics if infected
  • surgery
58
Q

Symptoms of Bartholin Cysts

A
  • asymptomatic if small and not infected
  • pain with walking/sitting
  • unilateral edema
  • redness around gland
  • dyspareunia
  • abscess
59
Q

Ovarian Cyst

A

fluid-filled sac that forms on the ovary

60
Q

What are the 4 types of ovarian cysts?

A
  • Follicular
  • Corpus luteum
  • Theca lutein
  • Polycystic ovarian syndrome (PCOS)
61
Q

Polycystic Ovarian Syndrome

A

Most common endocrine condition of women of reproductive age

  • multiple inactive follicle cysts within ovary
  • interfere with ovarian function
  • multifaceted disorder
62
Q

What is the central pathogenesis for PCOS?

A

hyperandrogenemia or hyperinsulinemia