UTERINE FIBROIDS AND CYSTS

ANATOMY - FEMALE PELVIS

MENSTRUAL CYCLE

MENSTRUASI

•TUBUH SUDAH BERSEDIA UNTUK MELAHIRKAN ANAK.

•TIAP-TIAP BULAN TELUR DIKELUARKAN DARI OVARI. RAHIM PULA DISALUTI SATU LAPISAN DARAH UNTUK MENERIMA JANIN JIKA PEREMPUAN ITU MENGANDUNG.

•JIKA TIADA SEKS DAN PERSENYAWAAN, TIADA JANIN. SELAPUT DARAH ITU AKAN DENGAN SENDIRINYA LURUH/DIGUGURKAN.

•INI DIPANGGIL DARAH HAID.

Classification of menstrual disorders

•Amenorrhea and oligomenorrhea

•Dysmenorrhea

•

•Menorrhagia

UTERINE FIBROID

What are fibroids?

*Fibroids are muscular tumors that grow in the wall of the uterus (womb).

*Fibroids can grow as a single tumor, or there can be many of them in the uterus.

*They can be as small as an apple seed or as big as a grapefruit.

*In unusual cases they can become very large.

Why should women know about fibroids?

•About 20 percent to 80 percent of women develop fibroids by the time they reach age 50.

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•Fibroids are most common in women in their 40s and early 50s.

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•Not all women with fibroids have symptoms.

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•Women who do have symptoms often find fibroids hard to live with.

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•Some have pain and heavy menstrual bleeding.

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•Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure.

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•Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.

 Who gets fibroids?

There are factors that can increase a woman's risk of developing fibroids.

•Age.

  Especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.

•Family history.

If a woman's mother had fibroids, her risk of having them is about three times higher than average.

•Ethnic origin.

African-American women are more likely to develop fibroids than white women.

•Obesity.

Women who are overweight are at higher risk for fibroids.

•Eating habits.

Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

What are the

symptoms of fibroids?

Most fibroids do not cause any symptoms, but some women with fibroids can have:

•Heavy bleeding (which can be heavy enough to cause anemia) or

•painful periods

•Feeling of fullness in the pelvic area (lower stomach area)

•Enlargement of the lower abdomen

•Frequent urination

•Pain during sex

•Lower back pain

•Complications during pregnancy and labor, including a six-time greater risk of cesarean section

•Reproductive problems

Where can fibroids grow?

Submucosal   -  fibroids grow into the uterine cavity.

Intramural   -  fibroids grow within the wall of the  uterus.

Subserosal    -  fibroids grow on the outside of the   uterus.

What causes fibroids?

No one knows for sure what causes fibroids. Researchers think that more than one factor could play a role. 

These factors could be:

•hormonal (affected by estrogen and 

 progesterone levels)

•genetic (runs in families)

They grow rapidly during pregnancy, when hormone levels are high. They shrink when anti-hormone medication is used. They also stop growing or shrink once a woman reaches menopause.

Can fibroids turn into cancer?

Fibroids are almost always benign (not cancerous).

Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma.

What if I become pregnant and have fibroids?

Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will be problems. Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroids are:

•Cesarean section.

The risk of needing a c-section is six times greater for women with fibroids.

•Baby is breech.

The baby is not positioned well for vaginal delivery.

•Labor fails to progress.

•Placental abruption. The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus does not get enough oxygen.

•Preterm delivery.

Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

How do I know for sure that I have fibroids?

Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina.

The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus.

Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant.

For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.

How do I know for sure that I have fibroids?

Your doctor can do imaging tests to confirm that you have fibroids.

These are tests that create a "picture" of the inside of your body without surgery.

These tests might include:

Ultrasound

Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.

How do I know for sure that I have fibroids?

Your doctor can do imaging tests to confirm that you have fibroids.

These are tests that create a "picture" of the inside of your body without surgery.

These tests might include:

Magnetic Resonance Imaging (MRI)

Uses magnets and radio waves to produce the picture.

How are fibroids treated?

Most women with fibroids do not have any symptoms.

Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment. Some of these things include:

*whether or not you are having symptoms from the fibroids.

*if you might want to become pregnant in the future

the size of the fibroids.

How are fibroids treated?

Most women with fibroids do not have any symptoms.

•the location of the fibroids

•your age and how close to menopause you might be

If you have fibroids but do not have any symptoms, you may not need treatment.

Your doctor will check during your regular exams to see if they have grown.

How are fibroids treated?

vMedications

vSurgery

vMyomectomy

vHysterectomy

vEndometrial Ablation

vMyolysis

vUterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE) - 

OVARIAN CYST

SYMPTOMS:

•NO SYMPTOMS

•ABDOMINAL DISTENSION

•PAIN

•PRESSURE SYMPTOMS

OVARIAN CANCER

Ovarian Cyst (Q&A)

1.      What is Ovarian Cyst ?

        An ovarian cyst is a sac filled with liquid or semi-liquid material that arises in an ovary (see the image below). Although the discovery of an ovarian cyst causes considerable anxiety in women owing to fears of malignancy, the vast majority of these lesions are benign.

2.      Types of Ovarian Cyst ?

         There are various types of ovarian cysts, such as dermoid cysts and endometrioma cysts. However, functional cysts are the most common type. The two(2) types of Functional Cysts include Follicle and Corpus Luteum Cysts.

• Follicle cyst : During a woman’s menstrual cycle, an egg grows in a sac called a follicle. This sac is located inside the ovaries. In most cases, this follicle or sac breaks open and releases an egg. But if the follicle doesn’t break open, the fluid inside the follicle can form a cyst on the ovary.

• Corpus luteum cysts : Follicle sacs typically dissolve after releasing an egg. But if the sac doesn’t dissolve and the opening of the follicle seals, additional fluid can develop inside the sac and this accumulation of fluid causes a corpus luteum cyst.

Other Types of Cysts : 

• Dermoid cysts  : sac-like growths on the ovaries that can contain hair, fat, and other   tissues.
• Cystadenomas  : non-cancerous growths that can develop on the outer surface of the ovaries.
• Endometriomas : tissues that normally grow inside the uterus can develop outside the uterus and attach to the ovaries, resulting in a cyst. 

Some women develop a condition called Polycystic Ovary Syndrome (PCOS). This condition means the ovaries contain a large number of small cysts. It can cause the ovaries to enlarge, and if left untreated, polycystic ovaries can cause infertility.

3.      Symptoms of Ovarian Cyst ?

·         MOSTLY ASYMPTOMATIC, Detected coincidently during the USG check up.

·         Pain or bloating in the abdomen.

·         Difficulty urinating, or frequent need to urinate.

·         Dull ache in the lower back.

·         Pain during sexual intercourse.

·         Painful menstruation and abnormal bleeding.

·         Weight gain.

·         Nausea or vomiting.

·         Loss of appetite, feeling full quickly.

4.      Treatment for Ovarian Cyst ?

Functional ovarian cysts often DO NOT need treatment. They often go away on their own within 8 to 12 weeks.

If you have frequent cysts, you may prescribe birth control pills (oral contraceptives). These medicines may reduce the risk of developing new ovarian cysts. Birth control pills do not decrease the size of current cysts.

Surgery to remove the cyst or ovary may be needed to make sure that it is not ovarian cancer. Surgery is more likely to be needed for:

·         Complex ovarian cysts that do not go away with oral treatment.

·         Cysts that are causing symptoms and do not go away.

·         Simple ovarian cysts that are larger than 10 centimeters.

·         Women who are near menopause or post menopause.

Types of surgery for ovarian cysts include:

·         Exploratory laparotomy, is done when the tumor/cyst is BIG in size or the tumor/cyst is suspected to be Malignancy.

·         Pelvic LAPAROSCOPY to remove the cyst or the ovary, latest method in current globalization world with less invasion and fast recovery.

(see the video below)