A. Definition of myoma uteriMyoma uteri are benign neoplasms derived from uterine muscle is also called Uterine Fibroids or leiomyoma uteri. Myoma uteri generally occurs at the age of 35 years. There
are two places of origin are known myoma uteri which the cervix uteri
(2%) and corpus uteri (97%), has never been found myoma uteri occurs
before menarche.
B. The etiology of myoma uteriAlthough
myoma uteri was found to occur with no obvious cause, but from the
research and Lipschlutz Miller said that myoma uteri occurs depends on
immature muscle cells contained in the "Cell Nest" which can then be
continuously stimulated by the hormone estrogen.
C. Localization myomas uteri1. Intramural myomas; When the tumor is in its growth remained in the uterine wall.2. Myomas Submukosum; myomas that grow toward the uterine cavity and the cavity was prominent.3. Myomas Subserosum; myomas that grow outward and stand on the surface of the uterus.
D. Complications of myoma uteri1. Growth leimiosarkoma.Suspected uterine sarcoma when enlarged for several years, suddenly - suddenly becomes big when it happens after menopause2. Torque (round shaft)There are times when stalk on myoma uteri experiencing subserosum round. If
this process occurs suddenly, the tumor will experience acute
circulatory disorders with tissue necrosis and it would seem the
clinical picture of abdomenakut.3. Necrosis and InfectionIn
myoma subserosum the polyp, tumor end, sometimes it can be through the
cervical canal and was born from the vagina, in this case the
possibility of interference with the situation by necrosis and secondary
infection.A. Diagnostic Examination of myoma uteri1. Examination Complete Blood: Hb: dropped, Albumin: down, leukocytes: down / up, Erythrocytes: down2. Ultrasound: visible mass in the region of the uterus.3. Vaginal toucher: obtained vaginal bleeding, palpable mass, consistency and size.4. Cytology: determine the degree of malignancy of the neoplastic cells.,5. Rontgen: to find abnormalities that may exist that could hinder surgery.6. ECG: Detecting abnormalities that may occur, which may affect the surgery.B. How myomas Handling uteriIndication of uterine myoma uteri were removed uteri subserosum is stemmed. In
myoma uteri are still small especially in patients approaching
menopause treatment is not necessary, just do regular pelvic
examinations every three months or six months. The
handling of the myoma uteri that needs to be addressed is the operative
treatment of them is with a hysterectomy and total abdominal
hysterectomy generally. Measures total hysterectomy is known as Total Abdominal Histerektomy and Salphingo Bilateral oophorectomy (TAH-BSO). TAH-BSO
is a surgery to remove the uterus, cervix, ovaries and both fallopian
falofii by making an incision in the wall, abdominal neoplasmatic
malignant disease, and chronic leymyoma endrometriosis (Tucker, Susan
Martin, 1998).C. Nursing Diagnosis myoma uteri•
Impaired urinary elimination (retained) are associated with suppression
by neoplasm tissue mass in the region sekitarnnya, impaired sensory /
motor.• Impaired sense of comfort (pain) associated with tissue damage•
disturbance of self-concept relates to concerns about the inability to
have children, change in female issues, due to the sexual relationship.• High risk of hypovolemic shock associated with hemorrhage repeated.•
Lack of knowledge about the condition, prognosis and treatment needs
related to misinterpretation of information, do not know the source of
information.Nursing Plan of myoma uteriDX1Impaired
sense of comfort (pain) associated with tissue damage and nervous
system caused by narrowing of the cervical canal by myomaDestinationClients
can control the pain with the criteria the results were able to
identify how to reduce pain, expressing a desire to control the pain.Interventions and Rational1. Observation of pain and level of pain.Facilitate nursing actions2. Teach and record the type of pain and act of to cope with painImprove client perception of the pain they experienced.3. Teach relaxation techniquesIncrease client comfort4. Recommended to use warm compressesHelps reduce pain and enhance client comfort5. Collaboration of analgesicReduce painDx 2Impaired
urinary elimination (retained) are associated with suppression of the
neoplastic tissue mass in the region sekitarnnya, impaired sensory /
motor.DestinationMaternal
urinary elimination pattern returns to normal with the mother
understands the outcome criteria urinary retention, are willing to take
action to reduce or eliminate urinary retention.Interventions and Rational1. Record and monitor expenditure patterns of micturition urineSeeing clients elimination pattern changes2. Perform palpation of the bladder, observing the discomfort and pain.Determining the level of pain experienced by the client3. Encourage clients to stimulate micturition with warm water delivery, posture, flowing tap water.Preventing urinary retention
Bibliography• Department of Obstetrics & Gynecology, Faculty of Medicine. Unpad. 1993. Gynecology. Elstar. Bandung• Carpenito, Lynda Juall, 2000. Handbook of Nursing Diagnosis. Edition 8. EGC. Jakarta• Galle, Danielle. Charette, Jane.2000. Oncology Nursing care plan. EGC. Jakarta• Hartono, Poedjo. 2000. Cervical Cancer / Cervical Screening & Problems in Indonesia. Pre-congress courses Kogi XI Denpasar. Pulpit vol.5 2 May 2001• Saifidin, Abdul Bari, et al. , 2001. National Reference Books for Maternal and Neonatal Health Services. Yayasan Bina Library Sarwono Prawirohardjo & JNKKR-POGI. Jakarta