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Reproductive system
Precocious puberty
Delayed puberty
Klinefelter syndrome
Turner syndrome
Androgen insensitivity syndrome
5-alpha-reductase deficiency
Kallmann syndrome
Hypospadias and epispadias
Bladder exstrophy
Priapism
Penile cancer
Prostatitis
Benign prostatic hyperplasia
Prostate cancer
Cryptorchidism
Inguinal hernia
Varicocele
Epididymitis
Orchitis
Testicular torsion
Testicular cancer
Erectile dysfunction
Male hypoactive sexual desire disorder
Amenorrhea
Ovarian cyst
Premature ovarian failure
Polycystic ovary syndrome
Ovarian torsion
Krukenberg tumor
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
Germ cell ovarian tumor
Uterine fibroid
Endometriosis
Endometritis
Endometrial hyperplasia
Endometrial cancer
Choriocarcinoma
Cervical cancer
Pelvic inflammatory disease
Urethritis
Female sexual interest and arousal disorder
Orgasmic dysfunction
Genito-pelvic pain and penetration disorder
Mastitis
Fibrocystic breast changes
Intraductal papilloma
Phyllodes tumor
Paget disease of the breast
Breast cancer
Hyperemesis gravidarum
Gestational hypertension
Preeclampsia & eclampsia
Gestational diabetes
Cervical incompetence
Placenta previa
Placenta accreta
Placental abruption
Oligohydramnios
Polyhydramnios
Potter sequence
Intrauterine growth restriction
Preterm labor
Postpartum hemorrhage
Chorioamnionitis
Congenital toxoplasmosis
Congenital cytomegalovirus (NORD)
Congenital syphilis
Neonatal conjunctivitis
Neonatal herpes simplex
Congenital rubella syndrome
Neonatal sepsis
Neonatal meningitis
Miscarriage
Gestational trophoblastic disease
Ectopic pregnancy
Fetal hydantoin syndrome
Fetal alcohol syndrome
Disorders of sex chromosomes: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Ovarian cysts and tumors: Pathology review
Cervical cancer: Pathology review
Vaginal and vulvar disorders: Pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sexual development and sex hormones: Pathology review
Amenorrhea: Pathology Review
Testicular and scrotal conditions: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
HIV and AIDS: Pathology review
Penile conditions: Pathology review
Uterine disorders: Pathology review
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Jung Hee Lee, MScBMC
Antonia Syrnioti, MD
Sam Gillespie, BSc
Evan Debevec-McKenney
29-year-old Carmen presents to the physician’s office complaining of severe lower abdominal pain during her menstrual periods as well as pain during intercourse.
She has been trying unsuccessfully to get pregnant for the first time for the past 2 years.
Pelvic examination shows a normal sized uterus.
Later that day, 44-year-old Susanna comes to her physician reporting heavy menstrual periods that last about 10 days.
This has been occurring for the past 6 months and is accompanied with a feeling of “fullness” in the lower abdomen as well as fatigue.
On further history, she has never been pregnant.
Physical examination shows an enlarged uterus with multiple round masses.
Laboratory studies reveal iron deficiency anemia.
Based on the initial presentation, Carmen and Susanna both have some form of uterine disorder.
Let’s first review physiology real quick.
The uterus consists of 3 layers, an outer layer called the perimetrium or the serosa, a middle smooth muscle layer called the myometrium, and the innermost layer, the endometrium.
The endometrium has two layers, an inner functional layer made up mainly of glands and supporting connective tissue, called stroma, and an outer thin basal layer which regenerates the overlying functional layer after each menstrual cycle.
Okay, now, the first uterine disorder is endometritis or inflammation of the endometrium.
This is usually caused by normal bacterial flora of the lower genital tract, meaning the cervix, vagina or external genital organs, that travel upwards into the endometrium.
Uterine disorders are conditions that affect the uterus, the female reproductive organ that is responsible for gestating a fertilized egg. Common uterine disorders endometritis, asherman syndrome, endometrial hyperplasia, endometrial polyps, endometriosis, and leiomyomas.
Endometritis refers to the acute or chronic inflammation of the endometrium due to invasion by bacteria normally found in the lower genital tract. Asherman syndrome involves intrauterine adhesions following procedures like dilation and curettage and can result in amenorrhea, infertility, or recurrent pregnancy loss. Endometrial hyperplasia is the excessive growth of the endometrial glands, most commonly caused by long-standing increased exposure to estrogen without the counteracting effect of progesterone.
There is also endometrial cancer, which is a type of cancer that begins in the lining of the uterus, called the endometrium. There can also be endometrial polyps, which are benign growths of the endometrial glands and stroma that protrude into the uterine cavity. Next, there is endometriosis in which there is the presence of endometrial tissue outside the endometrial cavity, usually on the ovaries, causing pelvic pain and bleeding that gets worse during menstruation. Finally, there are leiomyomas or uterine fibroids, which are extremely common benign smooth muscle tumors that usually develop in premenopausal women, in response to estrogen. Leiomyomas can present with abnormal uterine bleeding, pain, iron deficiency anemia, or fertility issues.
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