Uterine fibroids are benign (non-cancerous) tumours/growths arising from the muscle of the wall of the uterus.
The majority of fibroids do not cause symptoms. If symptomatic, the commonest symptom is that of heavy menstrual flow with some associated pain. Any acute pain related to fibroids is usually due to fibroid degeneration whereby the centre of the
fibroid undergoes cell death due to inadequate blood supply. This will manifest as pain over the lower central abdomen.
Acute fibroid degeneration does not require any surgical intervention. It is usually treated with anti-inflammatory medications.
Uterine cancers can arise from either the lining of the uterus (endometrial cancer) or much less commonly, from the muscle wall of the uterus (leiomyosarcoma cancer)
The common symptoms of Uterine Cancers include vaginal bleeding in between the usual menstrual periods or new onset after undergoing menopause. In more advanced stages, some lower abdominal pain can be expected.
The treatment of uterine cancer will be surgical removal with possible clearance of the involved lymph nodes.
A urinary tract infection usually starts from the bladder and is a result of a bacterial infection. If left untreated, the infection can ascend to the kidneys.
The symptoms of a Urinary Tract Infection include pain over the lower central abdominal region with a burning sensation on urination. Blood in the urine and frequent urination are also common symptoms
A Urinary Tract Infection of the bladder can usually be treated with oral antibiotics. In severe cases whereby the infection had spread to the kidneys, intravenous antibiotics will be required.
Pelvic Inflammatory Disease (PID) refers to an infection of one or more gynaecological/female reproductive organs. The infected organs include the fallopian tubes, ovaries, uterus and the lining of the pelvis (peritoneum). Pelvic Inflammatory Disease often occurs in association with a urinary tract infection. The common bacteria involved in PID include chlamydia and gonorrhoea, which are sexually transmitted. Additionally, other bacteria like Streptococcus can also cause PID but are not sexually transmitted.
Pelvic Inflammatory Disease starts off as lower abdominal discomfort which then progresses to severe pain. The pain can also localise to the centre or either side of the lower abdomen depending on the affected organs.
The treatment of Pelvic Inflammatory Disease usually involves oral or intravenous antibiotics. In cases with abscess formation, radiologically-guided tube drainage or open surgical drainage may be necessary.
An Ectopic Pregnancy refers to the implantation of the embryo outside of the uterus. The most common site of ectopic pregnancy is the fallopian tube. The ovary and other sites in the abdomen are much rarer sites of ectopic pregnancy.
An Ectopic Pregnancy invariably results in a rupture of the embryo as these sites outside of the uterus are not able to support the pregnancy till maturity. A ruptured Ectopic pregnancy will result in severe lower abdominal pain. The patient often also experiences low blood pressure, a racing heart rate and may have had fainting spells prior to admission.
Emergency surgery is needed for a ruptured Ectopic Pregnancy. This can often be done as a keyhole/laparoscopic surgery though an open surgery may be necessary if the patient is very unstable.
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