Uterus, Pelvic Floor & Incontinence Exam Q&A | Verified Questions with Detailed Correct Answers PDF | Women’s Health, Pelvic Anatomy & Continence Care | A+ Grade Accuracy

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UTERUS, PELVIC FLOOR, INCONTINENCE
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leiomyoma (fibroid)
Smooth muscle tumors of the uterus


Most common pelvic tumor in women
Prevalence increases with age during reproductive years
Rare in adolescence and after menopause


Develops from the myometrial cells of the uterus
Familial predisposition in some patients




Submucosal (FIGO 0, 1, 2)
Intramural (FIGO 3, 4, 5)
Subserosal (FIGO 6, 7)
Cervical is (FIGO 8)
where can leiomyomas be located?




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submucosal
what types of fibroids would be likely to cause bleeding since they are closely
associated with the endometrium?




subserosal
what types of fibroids would you be able to palpate on exam?




Symptoms
Asymptomatic
Heavy or prolonged menses
Bulk-related symptoms
Pelvic pain/pressure/bloating
Bowel or bladder changes
IVC compression
Reproductive dysfunction


Signs:
Large, firm, mobile, irregularly shaped uterus (subserosal most likely)
clinical presentation of leiomyomas




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Pelvic and transvaginal ultrasound
-Helps to differentiate submucosal, subserosal, and intramural location
Saline infused sonogram to evaluate the uterine cavity and differentiate
submucosal fibroid from a polyp
Hysteroscopy
diagnosis of leiomyomas




Homogenous, slightly hypoechoic mass
how do fibroids look on ultrasound?




Observation with serial sonograms
Progesterones
Combination contraceptives
Levonogestrel IUD
Tranexemic acid
Mifepristone to reduce bleeding and fibroid size
GnRH agonists (Lupron) can be used in conjunction with surgery:
-GnRH decreased -> decreased FSH/LH -> decreased ovarian estrogen ->
decreased estrogenic effect on the endometrium
-6 month limit secondary to side effects
Surgical treatment for symptomatic fibroids
treatment options for leiomyomas




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D&C
Myomectomy
how can you manage fibroids surgically if fertility is desired?




Uterine artery embolization
Hysterectomy
how can you manage fibroids surgically if fertility is not desired?




Anemia
In pregnancy
-Early pregnancy loss
-Infarction of the fibroid
-Interference with nutrition/growth of the fetus
-Malposition of the fetus
what are some complications of leiomyomas?




endometrial polyps
Growth attached to the endometrium that extends into the uterine cavity
etiology: Localized hyperplasia of endometrial cells




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