Ques. 1 Describe the backache of gynaecological origin?
Ans. Backache of Gynaecologic origin is generally due to a well-defined pelvic disorder. It is before puberty and uncommon after the menopause but is frequently reported during adult life. Gynaecologic backache is frequently associated with orthopedic, urologic, or neurologic difficulties. Most cases of gynaecologic backache represent referred pain. It includes many types of pain on the lower part of the back, viz. pain at the sacrum, coccyx, soreness on the back and sciatica.
Ques. 2 Describe the causes of backache of gynaecological origin?
Ans. Gynaecologic backache is frequently associated with orthopedic, urologic or neurologic difficulties. It may be due to any of the following causes.
- Inflammation of the pelvic contents.
- Invasion of pelvic tissues of bone by tumour or endometriosis.
- Obstruction to the genital tract.
- Torsion or constriction of the pelvic viscera.
- Congestion of internal genitalia.
- Psychic tension. Most cases of Gynaecologic backache represent referred pain (renal pain, rectal pain etc.).
- Traction or pulsion on the peritoneum or pelvic floor (tumours, ascite, uterine prolapsed etc.)
Ques. 3 How can we diagnose this type of backache?
Ans. DIAGNOSIS –
- Leucocytosis & an elevated E.S.R. may be indicative of infection.
- Vaginal cytology may reveal neoplastic cells.
- Bacteriuria, pyuria or haematuria suggests urinary tract disease as a possible cause of backache when catheterized or a clean-catch specimen is examined.
- Teste may reveal faulty posture, bony deformity, muscle spasm, and spinal cord or other back injury.
- X-ray (A.P. & lateral view) of the spine often discloses a postural, degenerative, neoplastic or other orthopedic cause of backache.
- Myelogram may be required to demonstrate a herniated intervertebral disk.
- Discomfort is usually more pronounced on the involved side.
- Gynaecologic backache is almost invariably associated with other major signs and symptoms of pelvic disease.
Ques. 4 How can you prevent this backache?
Ans. Many cases of gynaecologic backache can be prevented by avoiding trauma in labor and delivery, repairing cervical and other obstetric lacerations immediately, treating cervicitis and pelvic infection promptly and adequately, and by examining women periodi-cally so that tumors, hernias, & similar lesions can be treated early.
PROGNOSIS – Multiple causes of backache cloud prognosis. If the backache is of Gynaecologic origin, successful treatment of pelvic problem will almost always eliminate problem.
Ques. 5 What is the treatment of this?
Ans. TREATMENT –
- The patient is placed at bed rest in the most comfortable position on a firm mattress. Heat is applied to the back as necessary for pain, local massage of some liniment, analgesics may be given.
- Operative – tumors, malposition of the uterus, pelvic hernias, herniated intervertebral disk, etc. may require surgery.
- The underlying cause should be treated definitively.
Ques. 6 What are the causes of a Midline Hypogastric Swelling rising upto umbilicus in a woman of 35 years of age.
Ans. The probable causes of abdominal swellings are –
- Ovarian cysts or ovarian (malignant) tumor.
- Uterine fibroid.
- A broad ligament tumor.
- Hydatidiform mole.
- Mesenteric cysts.
- Tubo-ovarian masspyosalpinx or hydrosalpinx.
- Ectopic pregnancy.
- Pelvic abscess.
- Dropped kidney of spleen
- Distended bladder.