Benign conditions of the upper genital tract

1. Big picture

Benign conditions of the upper genital tract are non-malignant disorders affecting the uterine body, endometrium, myometrium, fallopian tubes, ovaries, adnexa, and pelvic peritoneum.

For the final exam, this topic is mainly about recognizing the clinical patterns of:

• Abnormal uterine bleeding → fibroids, endometrial polyps, adenomyosis, anovulation.
• Dysmenorrhoea and chronic pelvic pain → endometriosis, adenomyosis, fibroids.
• Infertility/subfertility → endometriosis, tubal disease, submucous fibroids, polyps, adhesions.
• Acute pelvic pain → ovarian torsion, ruptured ovarian cyst, pelvic inflammatory disease, tubo-ovarian abscess, ectopic pregnancy.
• Adnexal mass → functional cyst, endometrioma, dermoid cyst, cystadenoma, fibroma, malignancy until excluded.

The examiner wants you to think clinically:

Pain / bleeding / infertility / mass
↓
Pregnancy test if reproductive age
↓
Pelvic examination + transvaginal ultrasound
↓
Exclude malignancy and emergencies
↓
Choose conservative, medical, fertility-preserving, or surgical treatment

---