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Tuesday, June 24, 2014

PPT On Benign Uterine Tumour

Benign Uterine Tumour Presentation Transcript

    Leomyomas, also called myomas or fibroid of the uterus are benign tumor of the uterine muscles.

    Leomyomas are the most common tumour of the female genital tract. They occur in more than 20-30% of all women during their menstrual years. Firboids are more common in women approaching menopause.

 The exact cause is unknown. The growth of leomyomas seems to be related to estrogen stimulation because the fibroids often enlarge with pregnancy and decrease in size with menopause. Leomyomas begin as simple proliferation of smooth muscle cells. This proliferation is stimulated by physical or mechanical means and may occur at points of maximal stress within the myometrium. With the stress within the uterus as a result of contractions there are often multiple fibroids.

    Frequently leomyomas are asymptomatic, symptoms appear generally relate to tumour size, location and number. Abnormal bleeding resulting in hypermenorrhea.
Secondary Changes :
  • Hyalin degeneration : When tumour outgrows the blood supply.
  • Cystic degeneration : When the tumour becomes liquefied and ultimately cystic.
  • Calcification : more common in large tumours.
  • Infection : Which is more common in submucosal tumour.
  • Sarcomatus Degeneration : Rare and suspected with rapidly enlarging tumours.
  • Acute torsion of the pedicle which leads to acute disruption of blood supply with gangrenous changes and symptoms of acute abdomen.
  • Symptoms vary widely and occur in about half of women with leomyomas. They relate to the size,   location and number of the leomyomas.
  • The onset occur in late 410 and early 50 just before menopause.
  • The most common clinical manifestations are :-
  • Abnormal uterine bleeding recursive in amount or duration.
  • Associated with anaemia.
  • Tiredness, lethargy and weakness.
  • Urinary frequency is common as tumour probes on the bladder.
  • Urinary retention, constipation and abdominal pain are less common symptoms. 
6.DIAGNOSTIC ASSESSMENT : A characteristic history, confirmed by abdominal and pelvic examination findings establishes the diagnosis.Ultrasonography may indicate an abnormal uterine shape. Various disorders such as cancer or a problem pregnancy may be ruled out before treatment is planned.

  •  Plan of treatment depends on symptoms, age, location and size of the tumours, onset of complications and the client’s desire to become pregnant.
  •  If a woman is near to menopause and uterus size is small then conservative treatment is given. If the client experiences rapid increase in the size of the leomyomas more definitive therapy that is myomactomy is done.
    Younger, asymptomatic women may require no treatment. When definitive treatment is indicated such as myomactomy (removal of a tumour without removal of the uterus). Uterine leiomyomas are a common indication for a hysterectomy.

    Many women may be asymptomatic, however many will seek medical help because of abnormal uterine bleeding. The nurse must obtain a thorough history from the client and assess the knowledge of her condition and the surgery if planned.
  • Nursing Diagnosis : Knowledge deficit related to surgical procedure and possible outcome
  • Planning : Expected outcome : The client will discuss surgery and outcomes.
  • Implementation : The woman needs assistance in understanding her problem and the surgery being performed to correct it, either a myomectomy or a hysterectomy. She needs informations as how to care for herself postoperatively. If she had myomectomy, pregnancy is still option and she must continue to receive regular gynecologic examinations. If she had a total abdominal hysterectomy with bilateral salpingo oophorectomy, menopause and estrogen replacement therapy should be discussed. 


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