1. BENIGN TUMOURS,CYSTS
&
MALFORMATIONS OF THE
GENITAL TRACT
WAQAR SAEED
09-122

2. MALFORMATIONS OF
THE GENITAL TRACT

4. I. THE MALFORMATIONS
1.Faliure of Recanalization:
- Imperforate hymen or
transverse septum
- Cruciate Incision in the hymen
2.Failure of Ducts to form or fuse:

6. FAILURE OF DUCTS
TO FUSE

7. BENIGN CYSTS OF VULVA
- Bartholin cysts
- Skene Gland cysts
- Mucus inclusion cysts
with or without vulval discomfort

8. BARTHOLIN CYSTS

9. MARSUPIALIZATION OF CYST

10. II. VULVAL CANCERS
•VULVAL TUMORS:
- Similar to those that arise in skin
- Vulval varicosities

11. VAGINAL CANCER
VAGINAL TUMORS: ( Rare)
- Cysts
- Gartner Duct Cyst
- Urethral Diverticulum
- Myoma

12. THE TUMORS…
CERVICAL TUMORS:
 Cervical Polyp:
- Most common
- Columnar to squamous
metaplasia
- May ulcerate
- Intermittent/postcoital bleed
- Remove by twisting pedicle

13. THE TUMORS….
Cervical Tumors:
 Genital Papillomata
 Fibroids

14. THE TUMORS…
UTERINE TUMORS:
1.)Endometrial Polyps
- Associated with endometrial
hyperplasia
- Abnormal uterine bleeding
- Detected by curettage or by
hysteroscopy.

15. THE TUMORS…
2.) Uterine Fibroids:
 Gen. Considerations:
- Most common tumor of the GT
- Smooth muscle fibers interspersed
with connective tissue
- More common in nulliparous women
- Etiology unclear
- Post Menopausal Atrophy
- Types

16.  Symptoms:
- Depend on size and position of fibroid
- Mostly asymptomatic
- Abnormal uterine bleeding
- Pelvic pressure and discomfort
 Diagnosis:
- On PA
- Pelvic U/S

17. Management:
i) Observe
ii) Myomectomy
iii) Hysterectomy
iv) GnRH analogues

18. Effect of:
i) Pregnancy on Fibroid:
“ Red Degeneration”
ii) Fibroid on Pregnancy:
- Spontaneous Miscarriage
- Large tumor malpresentation of
fetus
- Can Obstruct Labour
- Bladder/Bowel Symptoms
- PPH

19. Manage Fibroid in Pregnancy:
- * AVOID Myomectomy
- If labour obstructed go for CS

20. BENIGN OVARIAN CYSTS
&
TUMORS
-Ovary consists of:
- Coelomic Epithelium
- Oocytes
- Mesenchymal elements that form
medulla

21. BENIGN OVARIAN CYSTS
&
TUMOURS
 CLASSIFICATION:
TUMOR Cell Origin Type Incidence
Functional Cysts Normal Follicle Cystic 24
Serous
Cystadenoma
Coelomic
Epitelium
Cystic 20
Mucinous
CYstadenoma
Coelomic
Epithelium
Cystic 20
Teratoma
(Dermoid Cyst)
Oogonia Cystic 15
Endometrioma Ectopic
Endometrium
Cystic 10
Fibroma Mesenchyme Solid 5

22. BENIGN OVARIAN CYSTS
&
TUMOURS
1.) FUNCTIONAL CYST:
- Enlargement of unruptured Graffian
follicle
- Unilat. < 5cm
- May secrete estrogen resulting in
menorrhagia
- TVS for diagnosis

23. Rx:
- Observe ( 2-3 months)
- Aspirate under U/S & laproscopic guidance
- If Blood stained aspirate  Laprotomy
- Multilocular cyst  Surgical removal

24. BENIGN OVARIAN CYSTS
&
TUMOURS
2.) Mucinous Cystadenoma:
- B/w age 35-55
- Usually unilat.
- Lined by Columnar cells
- Psuedomyxoma peritonei
3.) Serous Cystadenoma:
- Age b/w 35-55
- Cuboidal Lining
- 1/3 may have malignant change

25. BENIGN OVARIAN CYSTS
&
TUMOURS
4.) Endometrioma:
- Chocolate Cyst
- Rx as Endometriosis
5.) Benign Teratoma:
( Dermoid Cyst)
- Age 20-40
- Epithelial,Endothelial, Mesothelial
elements

26. BENIGN OVARIAN CYSTS
&
TUMOURS
6.) Connective Tissue Neoplasm:
- Fibromas
- 10% Bilateral
- Meig’s Symdrome??
- Diagnosis by TVS

27. BENIGN OVARIAN CYSTS
&
TUMOURS
Management:
- Surgical
- Young Cystectomy
- BSO TAH