TUMOR JINAK

ORGAN
REPRODUKSI

dr.Rahmanita Sinaga,MKed(OG),SpOG
 TUJUAN INSTRUKSIONAL UMUM (TIU)
Setelah mengikuti pendidikan cabang ilmu ini
peserta didik mampu memahami dan menjelaskan
mengenai Tumor jinak Organ Reproduksi

 TUJUAN INSTRUKSIONAL KHUSUS (TIK)

Pada akhir mata kuliah ini mahasiswa mampu
memahami dan menjelaskan defenisi, etiologi
faktor resiko dan manifestasi klinis dari polip
serviks, , kista ovarium, teratoma ovarium (kista
dermoid), torsio dan ruptur kista ovarium, serta
mioma uteri.
 CERVICAL POLYPS

• pedunculated masses that protrude and

arise from the endocervical canal or
from the ectocervix.
• common benign growths of the cervix and have
a malignancy rate of 0.1-0.5%.
• Causes of cervical polyps for most are unknown
or from a secondary reaction to a cervical
inflammation.
SIGNS AND
SYMPTOMS

 No symptoms, usually painless.

 Intermenstrual bleeding
 Postcoital spotting or bleeding.
 Bleeding after douching or pelvic
exam.
 Infertility and recurrent miscarriage.
DIAGNOSIS
• Most often first recognized on routine speculum
exam
• Pedunculated, usually single, variation in size
from a few millimeters to 3-4 centimeters (if
large, may dilate cervix).
• Arising from endocervix more common than
from ectocervix.
• Smooth, soft, reddish purple to grayish white
and may readily bleed when touched.

ocument findings in descriptive terms--size, location, color,

consistency, and any bleeding.
MANAGEMENT
1. Reevaluate at routine exams for re-growth or
recurrence of polyps.

2. Treatment/management for polypectomy:

a. Identify the location of the base of the polyp .
b. Grasp the base of the polyp with an
appropriate size clamp and avulse it with a
twisting motion.
c. Some clinicians gently cure the base after
removal.
3. Send the specimen to pathology for histological
diagnosis  rule out a neoplastic process
4. Bleeding may be controlled with pressure,
monsel's solution, electrocautery, cryocautery, or
silver nitrate.
5. Ask client to return for reassessment if
abnormal vaginal bleeding continues after polyp
removal.
6. Review safer sex education.

  Removal is usually indicated since it may

cause irritation and bleeding. It is also necessary
to rule out a neoplastic process.
TUMOR JINAK UTERUS :
MIOMA UTERI

Tumor jinak pada otot polos uterus

Biasanya asimptomatik, tergantung ukuran dan lokasi

Meningkat pada wanita usia reproduksi, menurun pada usia

menopauese  pengaruh estrogen?  arises from a single
neoplastic cell within the smooth muscle of the myometrium
DIAGNOSA
 a.Anamnesa

 b. Pemeriksaan fisik  pembesaran abdomen, teraba

benjolan dengan konsistensi keras, berbatas tegas

 c. Pemeriksaan ginekologi 
• tampak massa keluar dari OUE (mioma geburt)
• Bisa disertai perdarahan pervaginam
• Pemeriksaan bimanual : teraba massa pada uterus,
permukaan halus, konsistensi keras

d.USG
TUMOR JINAK UTERUS :
ADENOMIOSIS

keberadaan endometrium di dalam

miometrium

memiliki batas yang buruk dan tidak dapat

enucleated, dapat melibatkan seluruh ketebalan
otot sampai ke serosa dan dapat bersifat “fokal”
atau “menyebar”.  uterus menjadi membesar dan
berbentuk globular

. dysmenorrhoea,dyspareunia and pelvic

pain.
TUMOR JINAK OVARIUM :
KISTA OVARIUM

• 60-80%
• serous, mucinous, endometrioid,
Epitel clear cell, and transitional cell
(Brenner) tumors

• 40-50%
Non • Teratoma matur/ kista dermoid
contain well-differentiated tissue
epitel/ derived from any of the 3 germ
germ cell cell layers, including hair and
teeth as ectodermal derivatives.
DIAGNOSA
 a.Anamnesa
 b. Pemeriksaan fisik  pembesaran abdomen,
teraba benjolan dengan konsistensi kistik,
 c. Pemeriksaan ginekologi 
• Pemeriksaan bimanual : teraba massa pada
adnexa, konsistensi kistik, permukaan halus
 d.USG
SINDROMA POLIKSITIK OVARIUM
 (NIH criteria to
ESHRE-ASRM
guidelines):

 2 dari 3 gejala
berikut :
• HIPERANDROGEN
• ANOVULASI KRONIK
• POLIKISTA OVARIUM
ULTRASONOGRAPHY

• 25 or more follicles per ovary

(superseding the earlier
Rotterdam criteria of 12 or more
follicles) 
• increased ovarian size (>10 cc)
 THE CLASSIC TRIAD OF PCOS

 oligomenorrhea
 hirsutism
 obesity
Insulin resistency
• Etiology ???????

• Hiperinsulinemia menurunkan SHBG hepar free testosteron

meningkat  pengaruh konsentrasi androgen bebas di organ perifer 
hirsutism,acne dan peningkatan distribusi lemak tubuh, haid irreguler
• Akumulasi lemak tubuh sitokin inflamasi  gangguan metabolik dan
hormonal
• Peningkatan sekresi LH dan penurunan FSH (akibat sekresi inhibn yang
ditingkatkan secara tidak langsung oleh insulin) gangguan
folikulogenesis
PENATALAKSANAAN

1. Modifikasi gaya hidup

2. Diet
3. Aktifitas fisik
4. Regulasi haid
5. Tatalaksana
infertilitas
REFERENSI
1.Berek,SJ, 2007.Gynecology.Fourteen
edition.Lippincott Williams Wilkins.

2. Wiknjosastro H, Saifuddin AB, Rachimhadhi ,

2007.. Ilmu Kandungan. Jakarta: Yayasan Bina
Pustaka Sarwono Prawirohardjo