Gynaecology

Gynaecology literally means 'the sciencewomen', butmedicine this isspecialtydiseases offemale reproductive system (uterus, vaginaovaries).

Tablecontents

1 Examination 2 Investigations 3 Diseases 4 Therapies 5 See also

Examination

Gynaecology isconsultant specialty. In most countries, women must seegeneral practitioner first. If their condition requires knowledge or equipment unavailable toGP, theyreferred togynaecologist.

Asallmedicine,main toolsdiagnosisclinical historyexamination. Gynaecological examinationspecialthat itquite intimate,thatinvolves special equipment --speculum. The speculum consiststwo hinged bladesflat metal, whichusedopenvagina,permit examination ofcervix uteri. Gynaecologists may also dobimanual examination (one hand onabdomen, two fingers invagina),palpateuterusovaries. Male gynaecologists often havefemale chaperone (nurse or medical student)their examination. Virginsnot usually examined vaginally. An abdominal ultrasoundused normallyconfirmbimanual examination.

Investigations

Some ofinvestigations usedgynecology are:

1. abdominal ultrasound,givelow-power view ofpelvic organs.
2. vaginal ultrasound. A probepassed intovagina, which allowsdetailed view ofuterusits contents. Goodearly pregnancy.
3. blood tests. Levelshormones such as estradiol, lutenising hormone, follicle-stimulating hormoneprogesteronemeasured.
4. hysteroscopy --fine tubepassed intouterus viacervix undergeneral anesthetic.
5. laparoscopy -- tubespassed intoperitoneal cavity, whichthen insufflatedcarbon dioxide. Thiscommonly useddiagnose endometriosis.

MRICT scansnot used. Pelvic X-rayrare. It can be useddelineateuterine cavityan injected dye (hysterosalpingogram) andmeasurepelvic girdle.

Diseases

The main conditions dealtbygynaecologist are:

1. cancer ofcervix. The Papanicolaou (Pap) smear ismeansdetecting this, by obtainingsamplecervical epithelial cellsexamining them undermicroscopemalignant changes. All womenencouragedhave pap smears at regular intervals (2 yearsAustralia) after commencing intercourse.
2. incontinenceurine.
3. amenorrhoea (absent periods)
4. dysmenorrhoea (painful periods)
5. infertility
6. menorrhagia (heavy periods). This ismain indicationhysterectomy.

Obviously theresome crossoverthese areas. Amenorrhoea inyoung girl may be referred topaediatrician, incontinence tourologist.

Therapies

Occasionally gynaecologists will use drugs, such as clomiphene (which stimulates ovulation), and, most famously, oral contraceptives (whichalso useddysmenorrhoea).

However, surgery ismain areatherapy. For historical reasons, gynaecologistsnot actually surgeons (this issourcesome tension).

Operations that gynaecologists do include:

1. terminationpregnancy
2. dilationcurettage (removal ofuterine contents,various reasons, including miscarriagemenorrhagia; procedurally very similar toabove);
3. hysterectomy (removal ofuterus);
4. colposuspension ('tightening' ofligaments aroundvagina,common therapyincontinencediscomfortolder women);
5. Large Loop Excision ofTransition Zone (LLETZ), wheresurface ofcervix, containing pre-cancerous cells identified on Pap smearremoved).

See also

• Vulvovaginal health
• Sexually transmitted diseases
• Pelvic inflammatory disease
• Hydatiform mole
• Cervical cancer
• Reproduction medicine
• Dalkon Shield
• Obstetrics