Benign diseases of the female sexual organs.

Prepared by N. Bahniy

Benign tumors of vulva

Papilloma

Bartholin's gland cyst

Lipoma

Fibroma

Hydradenoma

Gaertner cyst of the vagina- dysontogenetic

Vaginal Polyp• This is a rare tumor which can be seen in

infants or in adults. The origin from the vaginal

mucosa has to be demonstrated

to differentiate from much more

common urethral caruncles, cervical and

uterus polyps.

Vaginal fibroma

• Fibroma of the vagina is a very rare tumor. It may be pedunculated and

appear at the introitus.

Clinically it is a firm benign noninfiltrating

growth.

Cervix

Benign cervical lesions• Cervical erosion

• Leukoplakia (without atypia)

• Polyps• Endometriosis• Ectropion, scars• Exo-,

endocervicites

Algorithm for investigation

• Speculum exam• Pap smear,

bacterioscopy• Visual inspection after

application acetic solution

• Colposcopy• Biopsy

• A true ulcer with loss of epithelial covering is seen in the anterior lip of cervix

Cervical erosion

Ectropion

Cervical polyp

Fibroma of the cervix

Cervical endometriosis

UTERUS

Uterine leyomyoma (fibromyoma)

• Nodular• Multiple

• Laparoscopic view of a uterus with a pedunculated posterior myoma

• A fibroid in this location should not affect chances for pregnancy or miscarriage

• However, if it were pushing into the cavity of the uterus, it might cause problems

Protruded myoma

Treatment of women with uterine leiomyomas must be individualized, based on:Symptoms, Size and Rate of growth of the uterus, and The woman’s desire for fertility.

Hysterectomy Myomectomy >40 years complete her family large subserous-submucous and complicated large +ve complications (pressure Symptoms)

<40 years anxious to have children solitary-few-welldefined subserous (pedunclated) small to moderate no

Patient Age. Parity.

Fibroid

No

Type

Size Associated

Indications for surgical treatment

- a rapidly growing myoma - persistent abnormal

bleeding- Symptomatic myoma:

pain or pressure- Myoma sizes more

than 12 week of gestation

Operations: myomectomy or hysterectomy

Treatment of women with uterine leiomyomas must be individualized, based on:

1.Symptoms, 2.Size and 3.Rate of growth of the uterus, and 4.The woman’s desire for fertility.

EMA – embolization of uterine artery

Hysteroscopy in submucous myoma

Submucous myoma

Conservative treatment

• Gonadotropin-Releasing Hormone Agonists - should be restricted to a 3- to 6-month interval, following which regrowth of fibroids usually occurs within 12 weeks.

• estrogen–progestin combinations

• Gestagens (depot medroxy-progesterone acetate (Depo-Provera), IUD - MIRENA

• Danazol has been associated with a reduction in volume of the fibroid in the order of 20% to 25%.

Ovary

Ovarian cysts

Chocolate cyst

Dermoid Thin membrane, small sizes, conservative or surgery, rare complications

Conservative or Surgery: oophorectomy, ovarian resection

Ovarian cystomasSerous Cystadenoma

Bilateral cystadenoma

Papillary cystadenoma

Thick membrane, large sizes, surgery, most often complications

Torsion of the ovarian pedicle

Anatomical pedicle:•Ovarian lig•ov. Suspensory lig.•mesosalpinx

mesosalpinx

Surgical pedicle:•Ovarian lig•ov. Suspensory lig.•Mesosalpinx•Fallopian tube

Surgery - salpingooophorectomy