A Case Study on Submucous Myoma

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AUB prob 2 ® to Submucous Myoma
I. Data from Textbook
Submucous myoma has no known cause, it is idiopathic. Although there have been many theories developed. Some say it could be caused by increased Estrogen hormones. Some say that it is hereditary and has a tendency to run in the family.

Signs and Symptoms
Submucous myoma is generally symptomless. But some of its most common features were experienced by client ILN and they are: * Swollen breasts
* Loss of sex drive
* Profuse bleeding or heavy menstrual bleeding
* Hypermenorrhea
* Dysmenorrhea
* Metrorrhagia
* Masses palpated in the abdomen
* Pain
* Constipation and increased urination
* Increased abdominal girth or abnormally enlarged abdomen * Anemia like signs and symptoms (paleness, decrease respiratory rate, dizziness)

* Antibiotic treatment
* Hormone treatment
* Myomectomy
* Current trend presents Radio Frequency Energy which shrinks myomas and reduces symptoms in new minimally invasive procedure * TAHBSO (Total Abdominal Hysterectomy Bilateral Salphingo-oophorectomy)

Submucous Myomas may be diagnosed through many ways. They are palpated during pelvic examinations. An ultrasound is also done which could be the Transvaginal Ultrasoung and Vaginal Probe Ultrasound. Hysteroscopy may also be done wherein the uterus is being viewed.

Anatomy and Physiology of Affected Areas
The uterus consists of many structures like the ovaries, broad ligament, mesovarium, ovarium ligament and the like. Here are the detailed functions of each. ovary - One of the paired female reproductive organs which produce ova and female sex hormones, estrogens and progesterone; it is located laterally in the pelvic cavity, near the opening to the oviduct, and attached to the posterior surface of the broad ligament; it is regulated by FSH and LH from the anterior pituitary in a complex cycle which begins at puberty and ends at menopause.  See endoscopic views below: broad ligament - A broad fold of the peritoneum which extends from the side of the uterus to the wall of the pelvis, it helps hold the uterus, oviducts, and ovaries in place in the pelvic cavity.

mesovarium - The fold of peritoneum, a subsection of the broad ligament, connecting the over to the wall of the pelvic cavity. ovarian ligament - A cord or strap of dense fibrous connective tissue which is found between the folds of the broad ligament, passing from the side of the uterus to the lower end of the ovary; it helps hold the uterus and ovaries in place in the pelvic cavity. suspensory ligament - A band of the peritoneum containing dense fibrous connective tissue which extends upward from the upper pole of the ovary; it contains the ovarian vessels and nerve supply; it helps hold the ovary in place in the pelvic cavity. hilus (ovary) - The opening on medial side of the ovary which leads into the renal sinus and through which the ovarian blood vessels and nerves enter/leave the ovary germinal epithelium - A thin layer of simple cuboidal epithelium covering the ovary, a portion of visceral peritoneum, through which eggs are released at ovulation. stroma (ovary) - The coarse connective tissue framework of the ovary which contains irregular fibrous connective tissue (stroma) and the blood vessels and nerve supply, it is found in both the cortex and medulla of the ovary; the term may be used to generally describe the internal connective tissue structural framework of any organ. cortex (ovary) - The outer layer of the ovary which contains the various ovarian follicles interspersed by irregular fibrous connective tissue (stroma) and small blood vessels; the outer surface is covered by the germinal epithelium. medulla (ovary) - The inner layer of the ovary which contains dense irregular fibrous connective tissue (stroma) and the larger blood vessels and nerve supply of the ovary. The most affected area is the intrauterine wall...
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