Gynaecology

Jump to: navigation, search

WikiDoc Resources for Gynaecology

Articles

Most recent articles on Gynaecology

Most cited articles on Gynaecology

Review articles on Gynaecology

Articles on Gynaecology in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Gynaecology

Images of Gynaecology

Photos of Gynaecology

Podcasts & MP3s on Gynaecology

Videos on Gynaecology

Evidence Based Medicine

Cochrane Collaboration on Gynaecology

Bandolier on Gynaecology

TRIP on Gynaecology

Clinical Trials

Ongoing Trials on Gynaecology at Clinical Trials.gov

Trial results on Gynaecology

Clinical Trials on Gynaecology at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Gynaecology

NICE Guidance on Gynaecology

NHS PRODIGY Guidance

FDA on Gynaecology

CDC on Gynaecology

Books

Books on Gynaecology

News

Gynaecology in the news

Be alerted to news on Gynaecology

News trends on Gynaecology

Commentary

Blogs on Gynaecology

Definitions

Definitions of Gynaecology

Patient Resources / Community

Patient resources on Gynaecology

Discussion groups on Gynaecology

Patient Handouts on Gynaecology

Directions to Hospitals Treating Gynaecology

Risk calculators and risk factors for Gynaecology

Healthcare Provider Resources

Symptoms of Gynaecology

Causes & Risk Factors for Gynaecology

Diagnostic studies for Gynaecology

Treatment of Gynaecology

Continuing Medical Education (CME)

CME Programs on Gynaecology

International

Gynaecology en Espanol

Gynaecology en Francais

Business

Gynaecology in the Marketplace

Patents on Gynaecology

Experimental / Informatics

List of terms related to Gynaecology


Overview

The shamefulness associated with the examination of female genitalia has long inhibited the science of gynaecology. This 1822 drawing by Jacques-Pierre Maygnier shows a "compromise" procedure, in which the physician is kneeling before the woman but cannot see her genitalia. Modern gynaecology has shed these inhibitions.

Gynaecology or gynecology (see spelling differences) refers to the surgical specialty dealing with health of the female reproductive system (uterus, vagina and ovaries). Literally, outside medicine, it means "the science of women". Almost all modern gynaecologists are also obstetricians; see Obstetrics and gynaecology.

History

According to the Suda, the ancient Greek physician Soranus practiced in Alexandria and subsequently Rome. He was the chief representative of the school of physicians known as "Methodists." His treatise Gynaecology is extant (first published in 1838, later by V. Rose, in 1882, with a 6th-century Latin translation by Moschio, a physician of the same school).

In the United States, J. Marion Sims is considered the father of American gynaecology. Practitioners included Dr. Benjamin B. Weinstein (1913-1974) of Tulane University in New Orleans, who specialized in fertility studies.

Examination

Gynaecology is typically considered a consultant specialty. In some countries, women must first see a general practitioner (GP; also known as a family practitioner (FP)) prior to seeing a gynaecologist. If their condition requires training, knowledge, surgical technique, or equipment unavailable to the GP, the patient is then referred to a gynaecologist. In the United States, however, law and many health insurance plans allow/force gynaecologists to provide primary care in addition to aspects of their own specialty. With this option available, some women opt to see a gynaecological surgeon without another physician's referral.

As in all of medicine, the main tools of diagnosis are clinical history and examination. Gynaecological examination is quite intimate, moreso than a routine physical exam. It also requires unique instrumentation such as the speculum. The speculum consists of two hinged blades of concave metal or plastic which are used to retract the tissues of the vagina and permit examination of the cervix, the lower part of the uterus located within the upper portion of the vagina. Gynaecologists typically do a bimanual examination (one hand on the abdomen and one or two fingers in the vagina) to palpate the cervix, uterus, ovaries and bony pelvis. It is not uncommon to do a rectovaginal exam for complete evaluation of the pelvis, particularly if any suspicious masses are appreciated. Male gynaecologists often have a female chaperone (nurse or medical student) for their examination. An abdominal and/or vaginal ultrasound can be used to confirm any abnormalities appreciated with the bimanual examination or when indicated by the patient's history.

Diseases

The main conditions dealt with by a gynaecologist are:

  1. Cancer and pre-cancerous diseases of the reproductive organs including ovaries, fallopian tubes, uterus, vagina, and vulva
  2. Incontinence of urine.
  3. Amenorrhea (absent menstrual periods)
  4. Dysmenorrhoea (painful menstrual periods)
  5. Infertility
  6. Menorrhagia (heavy menstrual periods). This is a common indication for hysterectomy.
  7. Prolapse of pelvic organs
  8. Scabies

There is some crossover in these areas. For example a woman with incontinence may be referred to a urologist.

Therapies

As with all surgical specialties, gynaecologists may employ medical or surgical therapies (or many times, both), depending on the exact nature of the problem that they are treating. Pre- and post-operative medical management will often employ many "standard" drug therapies, such as antibiotics, diuretics, antihypertensives, and antiemetics. Additionally, gynaecologists make frequent use of "specialized" hormone-modulating therapies (such as Clomifene citrate and hormonal contraception) to treat disorders of the female genital tract that are responsive to pituitary and/or gonadal signals.

Surgery, however, is the mainstay of gynaecological therapy. For historical and political reasons, gynaecologists were previously not considered "surgeons", although this point has always been the source of some controversy. Modern advancements in both general surgery and gynaecology, however, have blurred many of the once rigid lines of distinction. The rise of sub-specialties within gynaecology which are primarily surgical in nature (for example urogynaecology and gynaecological oncology) have strengthened the reputations of gynaecologists as surgical practitioners, and many surgeons and surgical societies have come to view gynaecologists as comrades of sorts. As proof of this changing attitude, gynaecologists are now eligible for fellowship in both the American and Royal Colleges of Surgeons, and many newer surgical textbooks include chapters on (at least basic) gynaecological surgery.

Some of the more common operations that gynaecologists perform include:

  1. Dilation and curettage (removal of the uterine contents for various reasons, including partial miscarriage and dysfunctional uterine bleeding refractive to medical therapy)
  2. Hysterectomy (removal of the uterus)
  3. Oophorectomy (removal of the ovaries)
  4. Tubal ligation
  5. Hysteroscopy
  6. Diagnostic laparoscopy - used to diagnose and treat sources of pelvic and abdominal pain; perhaps most famously used to provide definitive diagnosis of endometriosis.
  7. Exploratory laparotomy - may be used to investigate the level of progression of benign or malignant disease, or to assess and repair damage to the pelvic organs.
  8. Various surgical treatments for urinary incontinence, including cystoscopy and sub-urethral slings.
  9. Surgical treatment of pelvic organ prolapse, including correction of cystocele and rectocele.
  10. Appendectomy - often performed to remove site of painful endometriosis implantation and/or prophylactically (against future acute appendicitis) at the time of hysterectomy or Cesarean section. May also be performed as part of a staging operation for ovarian cancer.
  11. Cervical Excision Procedures (including cryosurgery, LLETZ, LEEP) - removal of the surface of the cervix containing pre-cancerous cells which have been previously identified on Pap smear.

See also

External links

ar:طب النساء و التوليد bg:Гинекология ca:Ginecologia da:Gynækologi de:Gynäkologie et:Günekoloogia eo:Ginekologio eu:Ginekologia ga:Liacht bhan hr:Ginekologija io:Ginekologio id:Ginekologi ia:Gynecologia it:Ginecologia he:גינקולוגיה la:Gynaecologia et Obstetricia lt:Ginekologija nl:Gynaecologie no:Gynekologi qu:Warmi unquy hampikamayuq sq:Gjinekologjia sk:Gynekológia sl:Ginekologija sh:Ginekologija fi:Gynekologia sv:Gynekologi uk:Гінекологія




Linked-in.jpg