Common Gynaecological Conditions in Sri Lanka - hmislk/hmis GitHub Wiki

Common Gynaecological Conditions in Sri Lanka

Gynaecology covers non-pregnancy-related reproductive health. In Sri Lanka, issues often relate to infections, structural problems, and cancers, with higher prevalence in older or postmenopausal women. Hospital admissions may involve acute symptoms like pain or bleeding.

  1. Pelvic Organ Prolapse (e.g., Uterovaginal Prolapse): Highly prevalent, especially in geriatric women (62.4%), followed by cystocele (43.1%) and rectocele (9.5%). Common symptoms include vulval lumps, back pain, and urinary issues. It's a leading reason for hysterectomies in tertiary care.

  2. Cervical Cancer: The second most common female cancer (12% of new cases, age-standardized rate 9.6/100,000). Often presents late with vaginal discharge or bleeding. Screening via Pap tests is available at Well-Woman Clinics (42% uptake in 35-39 age group).

  3. Ovarian Cysts/Masses or Cancer: Abnormal masses prevalent in 2.9% of women over 40 (higher in >50 years or postmenopausal). Ovarian cancer is the fourth most common female cancer (8%, rate 6.7/100,000). Presentations include pain or bloating; histopathology may show endometriomas (common) or malignancies.

  4. Uterine Fibroids: Common benign tumors, affecting fertility and causing heavy bleeding or pain. Prevalence data is limited, but in South Asian women, it's linked to 15.5% of gynecologic issues in surveys. Often managed surgically.

  5. Endometriosis and Adenomyosis: Major causes of pain and infertility, with endometriosis in 13.2% of South Asian women in studies. More research is needed in Sri Lanka, but it's prioritized for regional studies due to impact on reproductive-age women.

  6. Polycystic Ovary Syndrome (PCOS): High in South Asians (17.3-20.5%), causing irregular periods, infertility (30-50% association), and metabolic issues. Often overlaps with obesity or diabetes.

  7. Abnormal Vaginal Discharge: A frequent complaint due to reproductive tract infections (RTIs) or STIs. Women often self-treat with cultural remedies, delaying care. It can signal underlying issues like cervical cancer or fistulae.

  8. Menopausal Symptoms: Prevalent in postmenopausal women, including hot flashes and urinary issues. Quality of life is often impaired.

  9. Uterine (Endometrial) Cancer: Eighth most common female cancer (3%, rate 2.8/100,000), rising with diabetes prevalence (25.5% in women).

In a women's hospital like the one in Galle, expect a mix of acute admissions (e.g., bleeding, pain) and referrals for surgeries (e.g., prolapse repairs, hysterectomies). National guidelines emphasize screening and multidisciplinary care. Data is from sources up to 2023-2025, as the latest DHS remains 2016 with no confirmed 2023-2024 update. If needed, consult the Family Health Bureau for local stats.

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