PELVIC MASS Uterus, Asymmetrical leiomyomata leiomyosarcoma Uterus, Symmetrical pregnancy adeno...
PELVIC MASS
Uterus, Asymmetrical
- leiomyomata
- leiomyosarcoma
Uterus, Symmetrical
- pregnancy
- adenomyosis
- endometrial ca
Adnexal, Ovarian
- corpus luteum cyst
- follicular cyst
- theca lutein cyst
- endometrioma
- inflammatory cyst (tubo-ovarian abscess)
- luteoma of pregnancy
- polycystic ovary
- benign neoplasms : dermoid cyst (most common)
- malignant neoplasms : granulosa cell tumour (most common)
Adnexal, Non-ovarian
Gynecological
- ectopic pregnancy
- pelvic adhesions
- paratubal cysts
- pyosalpinx/hydrosalpinx
- leiomyomata or fibroids
- primary fallopian tube neoplasms
Gastrointestinal
- appendiceal abscess
- diverticular abscess
- diverticulosis, diverticulitis
- carcinoma of rectum/colon
Genitourinary
- distended bladder
- pelvic kidney
- carcinoma of the bladder
DYSPAREUNIA
- atrophic vaginitis
- chemical vaginitis
- lichen sclerosis Candida vulvovaginitis
- Trichomonas vaginitis
- acute or chronic PID
- endometriosis
- fibroids
- adenomyosis
- congenital abnormalities of vagina e.g. septate vagina
- retroverted, retroflexed uterus may cause dyspareunia
- ovarian cysts/tumours
- symptomatic retroverted uterus
- psychological trauma
- vaginismus
- vulvodynia
PELVIC PAIN
Acute Pelvic Pain
Gynecological causes
- ectopic pregnancy
- abortion - missed, septic, etc...
- ruptured ovarian cyst
- torsion of ovary or tube
- hemorrhage into ovarian cyst, neoplasm
- degeneration of fibroid
- torsion of pedunculated fibroid
- acute PID
- mittelschmertz (ovulation pain as follicle ruptures into peritoneal space)
Non-gynecological causes
- appendicitis
- UTI - cystitis, pyelonephritis
- renal colic
- mesenteric adenitis
- diverticulitis
- inflammatory bowel disease
Chronic Pelvic Pain
- refers to pain of greater than 6 months duration
Gynecological causes of CPP
- chronic PID
- endometriosis
- adenomyosis
- invasive cervical ca (late)
- leiomyomata
- uterine prolapse
- adhesions
- cyclic pelvic pain
- primary dysmenorrhea
- secondary dysmenorrhea
- ovarian remnant syndrome
- pelvic congestion syndrome
- ovarian cyst
Non-gynecological causes
- referred pain
- urinary retention
- urethral syndrome
- penetrating neoplasms of GI tract
- irritable bowel syndrome
- partial bowel obstruction
- inflammatory bowel disease
- diverticulitis
- hernia formation
- nerve entrapment
- constipation
- psychological trauma
- 20% of CPP is due to history of previous sexual abuse/assault
