Leiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyoma varies from microscopic to giant; giant myoma is exceedingly rare. We report an unusual case of a large, cystic, uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT. A 39 year old infertile nulliparous woman presented with a history of lump in abdomen since 2 years and 6 months of amenorrhea. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy with total abdominal hysterectomy preserving tubes and ovaries. The histology revealed a leiomyoma with extensive hyaline degeneration. The current established management of uterine fibroids may include expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas. Leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.

INTRODUCTIONProlapse though not life threatening condition, severely affect quality of life in women causing physical, social, psychological, occupational, domestic limitations. 1 The incidence of urogenital prolapse increases with advancing age, menopause and parity.2 It is estimated that 50% of parous women lose pelvic floor support and, as a result, develop prolapse, but only 20% of these women are symptomatic. Anorectal dysfunction is probably less understood pelvic symptom in women with prolapse.These patients may experience pain with defecation, the need to splint or strain to have a bowel movement or anal incontinence. Meschia found a 2-fold increased risk of anal incontinence in patients with a rectocele greater than grade 2. Surgery is the definitive treatment.It is estimated that the lifetime risk of undergoing at least one surgical procedure for prolapse is 11% and the reoperation rate for recurrent prolapse is 30-40%. 3 The surgical indication should be based on the individual's symptoms rather than the degree of vaginal wall prolapse. ABSTRACTBackground: This study's objectives were to describe symptoms related to bowel symptoms in women with prolapse and to compare these symptoms as per the grading of posterior vaginal prolapse. Methods: Descriptive study, 63 women answered questionnaire for assessment of bowel function and were subjected to physical examination according to the International Continence Society's system for grading uterovaginal prolapse. Results: The distribution of pelvic organ support by overall POPQ stage was 6.4%stage 1,21%stage 2, 50% stage 3, and 23% stage 4. Women were asked to rate the extent to which they were bothered by their bowel function on a scale of 1 to 10, with 1 being not at all and 10 being extremely. Thirty-six women (58%) reported 1 to 4, 18 (29%) reported 5 to 7, and 8 (13%) reported greater than 8. According to the furthest extent of posterior vaginal prolapse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage I, 50 (35.2%) were in stage II, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV. Ninety-two percent of women reported having bowel movements at least every day. When asked whether straining was required for them to have a bowel movement, 67% reported never or rarely,3% reported sometimes,1.6%) reported always. When asked whether they ever needed to help stool come out by pushing with a finger in the vagina or rectum, 77.0% reported never or rarely, 15.1% reported sometimes, (5.6%) reported usually, and (1.6%) reported always. No women had fecal incontinence, there were no clinically significant associations between any of the questions related to bowel function and severity of posterior vaginal prolapse. Conclusions: Women with uterovaginal prolapse frequently have symptoms related to bowel dysfunction but this is not associated with the severity of posterior vaginal prolapse.

Background: Pelvic organ prolapse is a common, distressing and disabling condition affecting up to 30% of the women, 20- 60 years of age, attending Gynaecology outpatient clinics. Objective of present work was to know the effect of Pelvic Organ Prolapse (POP) on micturition symptoms.Methods: Descriptive study including 64 women presenting with POP symptoms. Subjects were evaluated using POP-Quantification system, Urinary Distress Inventory.Results: Women were asked to rate the extent to which they were bothered by their urinary function on a scale of 1 to 10, with 1 being not at all and 10 being extremely. Ten women (16%) reported 1 to 4, 23 (37%) reported 5 to 7, and 29 (47%) reported and gt;8.Conclusions: Strong association does exist between POP and micturition symptoms which are obstructive in nature and those causing urge incontinence.