(妇产科学教材）12.3Uterine myoma.pptVIP

Uterine Myoma;General Consideration; ;Classification;Pathology ;2. Microscopical structure;Degeneration;Degeneration;2. Cystic degeneration liquefaction of the areas of hyaline change, capsular space containing clear fluid ; Degeneration;4. Malignant transformation (sarcomatous change) rare 0.4%～0.8% ;Degeneration;Clinical Findings;Symptoms ;1. Abnormal uterine bleeding menorrhagia (prolonged, heavy menses) Where: large intramural myoma submucous myoma Why: Endometrium surface increases More blood surface Influence uterine contraction;irregular or increased menstrual bleeding;2. Lower abdominal mass hard mass no tenderness local discomfort ; 3. Pain rarely happen usually due to complications red degeneration torsion of pedunculated subserous myoma expelling of submucous myoma ;4. Pressure effects cervical myoma urination frequency and urgency of urination difficulty in urination retention of urine constipation; 5. Effects on pregnancy and childbearing submucous, intramural infertility (inability to conceive) abortion obstruct birth canal, difficult labor;Clinical Findings;Diagnosis;Ultrasound detected an abnormal echo in the uterine cavity;Differential Diagnosis ;Treatment; every 3～6 months small myoma with no symptom close to menopause; pretreatment for surgery contraindicated for surgery;(1)? Heavy or prolonged bleeding, especially causing anemia (2)??Torsion of subserous myoma (3)??Myoma with pressure effects (4) Myoma which cause infertility and recurrent abortion (5) Possible malignant change ;A. Myomectomy preserve fertility or uterus B. Hysterectomy subtotal ~ total ~ transabdominal, transvaginal, laparoscopy, hysteroscopy;How to consult:;Words for learning;Thanks for your attention!