Pocket Tutor Gynaecology Jodi Keane, Manda Raz, Shavi Fernando
INDEX
Note: Page numbers in bold or italic refer to tables or figures respectively.
A
Abdomen 33, 116
acute 161
Abdominal cavity 166, 245
Abdominal cramps, lower 165
Abdominal pain
cyclic 43
symptoms of 159
Abdominal palpation 34
Abdominal pressure 214
Abuse
physical 25, 30
sexual 25, 30
Acetic acid 228, 229
Acne 75
Acquired bleeding disorder 89
Activated partial thromboplastin time 87
Acute respiratory distress syndrome 159
Adapalene 83
Adenocarcinoma 238
Adenomyosis 68, 101
Adrenal androgen 45
production 46
Adrenarche 46
menarche 45
Amenorrhoea 70
causes of secondary 71
complete 74
eugonadotropic causes of 74
hypogonadotropic 70
causes of 76
physiological 71
causes of 72
primary 70
secondary 70
Amlodipine 67
Amsel's criteria 129
Anaemia 28, 86
chronic 28
Androgen
effects of 47
elevated 82
production of 52
Androstenedione 80
Anosmia 75
Anterior abdominal wall 16
anatomy 15
Anti-adrenal antibodies 74
Anti-androgen 83, 141
Anti-coagulant medication 89
Antidepressants, tricyclic 215, 217
Anti-phospholipid syndrome 171
Anti-sperm antibodies 135
Antral follicle count 81
Aortic dissection, risk of 73
Appendicectomy 30
Arteriovenous malformation 97
Artificial insemination 156
Asherman syndrome 153
Aspiration catheter 40
Assisted reproductive technology 156
complications of 159
Atrophic vulvovaginitis 130, 131
Auto-immune ovarian failure 74
Autonomic pelvic nerves 12, 14, 14
Axillae 47
B
Bacterial vaginosis 128
investigations 128
management 129
Bartholin's gland 116
Benzoyl peroxide 83
Beta-human chorionic gonadotropin 38
Bimanual palpation 34
Bimanual vaginal examination 34, 36
Biopsy 127
Bi-temporal hemianopia 75
Bladder 208
lesions 212
pressure sensors 213
trigone 186
Bleeding
abnormal 77
first trimester 160
heaviness, disorders of 69
inter-menstrual 117
menstrual 28
post-coital 117, 236
Blood loss
large volumes of 33
symptoms of 167
Blood pressure 193
Body
habitus 32
mass index 43, 55, 177
system 79
Bone mass 186
Bony pelvis 6, 7
greater 9
lesser 6
Bowel surgery 30
Breast
bud 54
cancer 191, 246
development of 49
growth 45
Breastfeeding 67
Bromocriptine 77
C
Cabergoline 77
Caesarean scars 166
Cancer
antigen 38
colorectal 86, 191
gynaecological 31, 221
non-epithelial 246
staging 224
and treatment, principles of 224
treatment 225
Candida 124
glabrata 125, 127
infections 125
Candidal discharge 125
Candidiasis 127
Carbohydrate consumption 82
Carcinoembryonic antigen 38
Cardiac disease 30
Cardiovascular disease 85, 191
Cell
cancers, transitional 214
clear 245
Central nervous system 54, 79
Central precocious puberty 53
Cervical 228
cytology 234
disease 28
environment 34
intra-epithelial neoplasia 233
motion tenderness 36, 118
secretions 125
smear 229
transformation zone 232
Cervical biopsy 233, 234
small 14
Cervical cancer 224, 238
assessment of 39
incidence of 230
Cervical screening 29
and cancer 230
methods 231
test 77, 87, 179, 221
Cervicitis, suspicion for 222
Cervix 3, 50, 95, 113, 116, 166
Chandelier sign 114
Chemotherapy 72, 249
Chlamydia 29, 77, 116, 118, 126, 140, 236
trachomatis 115, 116
Chloe's hormonal profile 44
Chloe's younger sister 44
Cholecystectomy 30
Choriocarcinoma 38, 221
Chorionic villi, hydatidiform swelling of 169
Chromosomal causes 61
Chromosomal genital abnormalities 64
Chronic pelvic pain 30, 31, 99, 108
management 111
Clitoris 11
Clomiphene citrate 84, 156
Coeliac disease 74, 86
Cognition 33
Coitus, vaginal lubricants for 195
Cold-knife conisation 235
Colposcopy 227, 229, 231
Combined oral contraceptive pill 82, 83, 90, 137, 138, 140, 142
Complete androgen insensitivity syndrome 58, 59, 61, 63, 64
diagnosis of 44
Condom 137, 143, 144
broken 150
male 138, 140
Cone biopsy 235
Congenital abnormalities 61
Congenital adrenal hyperplasia 55
Congenital disorder 43
Congenital hypothalamic malformation 75
Conjunctiva 116
Contraception 29, 82, 136, 148
emergency 149, 150
long-acting 146
methods of 29
natural methods 137
pearl index 136
permanent 97
short acting 137, 138
Contraceptive
category of 145
methods 29
pill 73
Copper intrauterine device 89, 148, 151
Corpus luteum, demise of 24
Cough 214, 240
Craniosacral outflow 14
C-reactive protein 37, 114, 123
Creatinine 160, 198
Cushing syndrome 75
Cyclical pelvic pain 66
Cyclooxygenase 101
Cyproterone acetate 82, 83, 141
Cystectomy 246
Cystic fibrosis 155
Cystitis cystica 214
Cystoscope, flexible 214
Cystoscopy 213, 214
D
Darifenacin 217
Decidua functionalis 23
Dehydroepiandrosterone sulphate 46, 53, 81
Delayed puberty 57
differential diagnosis 57
history and examination 57
investigations 61
management of 61, 62
Deoxyribonucleic acid 29, 231
Depot medroxyprogesterone acetate 145
Dermatitis, general 130, 131
Dermoid cysts 246
Desmopressin 90, 217
Desvenlafaxine 192
Developmental syndromes 63
Diabetes 80
mellitus, type 2 221
Dianne 82
Diaphragm 138, 140, 141
positioning of 141
Diclofenac sodium 96
Diethylstilbestrol 65
Dihydrotestosterone 83
Disc disease 111
Discharge 130
Donor sperm 156
Drugs
anti-androgenic 82
anti-muscarinic 217
Duloxetine, trial of 217
Dysgerminoma 246
Dyslipidaemia 188
Dysmenorrhoea 99102, 104, 130, 147
examination 102
features of 102
history 102
investigations 103
management 103
primary 48, 100, 101
secondary 100
Dyspareunia 130
Dysplasia 234
development of 231
higher risk of 232
high-grade 226, 232
severity of 233
Dysuria 197
history of 113
E
Ectopic endometrial implants 101
Ectopic pregnancy 31, 165, 166
diagnosis 167
management 167
risk of 115, 122
Eflornithine 83
Eisenmenger's syndrome 173
Ejaculatory dysfunction 154, 157
Electrolyte 76, 13, 198
Embryonic tissue 169
Endocervical swabs 34
Endocrine 79
Endogenous oestrone 238
Endometrial adenocarcinoma 223, 238
Endometrial biopsy 87, 243
Endometrial cancer 191, 240
clinical features 240
investigations and diagnosis 241
management 241
metastasises 240
Endometrial cycle 21, 23
Endometrial glands 23
Endometrial hyperplasia 33, 68, 84, 88, 90, 178
risk factor for 97
treatment of 85
Endometrial polyps 152
Endometrial tissue 40
Endometriosis 41, 66, 101, 105, 106, 153
deep infiltrating 106
history and examination 107
investigation 107
management 107
pathophysiology of 105, 106
sites 105
superficial 104, 106, 107
Endometrium 23
layers 22
End-organ complications 198
Ephedrine 155
Epigastric vessels, inferior 19
Epilepsy 143
Epiphyses 52
Epithelial ovarian cancer 38, 245
Erector spinae 10
Erythematous vaginal tissue 125
Ethinyl oestradiol tablets 70
Etonogestrel 115
Eugonadotropic delay 59
Extragenital tissue 113
Extra-uterine disease 244
F
Facial hirsutism 75
Faecal incontinence 207
Fallopian tube 3, 50, 51, 100, 116, 245
removal of 241
Female genital development, physiology of normal 50
Female genital tract 50, 61
development 1
Female reproductive tract 43
Femoral nerve 12, 13
Fertility
and contraception 130
low natural 144
management 136
Fetal anomaly, termination for 173
Fetal malformation 84
Fever 197
Fibroid 40, 68, 153
pre-existing 242
types of 91
Finasteride 83
Fitz–Hugh–Curtis syndrome 120, 121
Flank pain 197
Fluconazole 127
Fluid intake, moderate 216
Fluorouracil 132
Follicle-stimulating hormone 37, 44, 45, 48, 53, 58, 72, 76, 80, 155, 177
Fragile X syndrome 72, 73
G
Gabapentin 192
Galactorrhoea 75
Gamma-aminobutyric acid 193
Gardnerella vaginalis 128
Gastrointestinal irritation 82
Gastrointestinal system 109
Genetic
male fetus 59
problems 61
syndromes 57, 63
Genital complaints 113
Genital conditions 126
Genital diseases 113
management 114
Genital organs, external 1, 3
Genital region 113
Genital skin 129
Genital symptoms 26
treatment of 194
Genital tract
development of 1
examination of lower 227
Müllerian-derived 59
upper 50
Genitalia 47
development of
external 1
internal 1
external 4, 11, 32
internal 3, 50
Genitourinary tract 186
Germ cell 246
tumours 246, 249
Gestational diabetes 84
Gestational neoplasias 221
Gestational trophoblastic disease 160, 169
Glycated haemoglobin 81
Gonadotropin 44
Gonadotropin-releasing hormone 19, 45, 47, 48, 53, 72, 98
Gonorrhoea 29, 77, 116118, 126, 140
Granulosa tumours 246
Gynaecological assessment, part of 38
Gynaecological oncology, principles of 221
Gynaecological surgical incisions 18
Gynaecological system 109
H
Haematological tests 37
Haematuria 197
Haemoptysis 240
Haemorrhage, intra-abdominal 168
Hair
follicles 82
head 47
Headache 178
Heavy menses 28
Hepatitis 140
B 115
C 115
Herbal pills 177
Herpes simplex virus 115, 118
Hormonal therapy 187
Hormonal treatments 29
Hormone
anti-Müllerian 81
low follicle-stimulating 70
luteinising 19, 37, 45, 48, 53, 58, 70, 73, 76, 80
pills 142
replacement 54, 221
therapy 73
thyroid-stimulating 53, 76, 81
Horseshoe kidney 74
Human chorionic gonadotropin 76, 114, 123, 155
Human immunodeficiency virus 115, 140
Human papillomavirus 29, 132, 231, 237
dependent malignancy 226
infection with 226
screening 231
Hydatidiform mole 221
Hymen, imperforate 58, 59, 66
Hyper-androgenism 38
Hypergonadotropic amenorrhoea 71, 72, 72
causes of 73
Hypergonadotropic hypogonadism 60
Hypergonadotropic women 61
Hyperplasia 77
development of 189
Hyperprolactinaemia 75, 76
Hypertension 221
severe 178
Hypogastric nerve 14
Hypogonadotropic delay 59
Hypomenorrhoea 69
Hypothalamic dysfunction 70
Hypothalamic-pituitary
axis 45
ovarian 47, 48
axis 19
Hypothyroidism 89
Hysterectomy 90, 92
abdominal 93
approaches
contraindications 94
indications 94
types of 93
Hysteroscopic procedures 91
Hysteroscopy 243
diagnostic 40
I
Idiopathic ovarian failure 72
Imidazoles 127
Imipramine 155
Immune thrombocytopaenic purpura 87
Implanon 145, 146
NXT 147
In vitro fertilisation 158
Incontinence, investigation of 212
Infection 178, 236
types of 116
Infertility 84, 122, 135, 151
causes of 154
couple factor of 156
female factor 151
male factor 151, 154
treatment for 153
tubal factor 152
uterine causes of 153
Inflammatory bowel disease 86, 111
Inguinal lymph nodes 229
Inherited chromosomal abnormalities 171
Insulin sensitiser 83
Internal genital
organs 1, 3
systems 50
Intra-abdominal pathology 34, 41
Intra-cytoplasmic sperm injection 154, 158, 158
Intra-peritoneal uterosacral ligaments 206
Intra-uterine adhesions 153
Intra-uterine contraceptive device 86
Intra-uterine device 14, 75, 145, 147
levonorgestrel 145, 146
mirena 145, 147
multiload copper 147
Intra-uterine growth restriction 53
Intra-uterine insemination 154, 157
Intra-uterine pathology 34
Intra-uterine system 77, 111, 189
Intra-venous pyelogram 239
Invasive testing 213
Iron deficiency 28, 68
anaemia 69, 86
Iron supplementation 67
Irregular menses, separating 77
Irregular periods 28
Ischial tuberosities 8
Isolated premature thelarche 55
Isotretinoin 83
J
Joint pain 183
K
Kallmann syndrome 75
L
Lactate dehydrogenase 243
Laparoscopic abdominal operations 30
Laparoscopic hysterectomy 93, 241
Laparoscopic tubal ligation 148
Laparoscopy
diagnostic 41
incision 19
Leiomyosarcoma 242
Letrozole 84, 156
Leucocytosis 37
Lichen sclerosis 126, 129131
Lichen simplex 130, 131
Limb nerve plexus traversing pelvis 12
Liver function test 76, 123, 160
Lower limb, nerve plexuses to 11
Low-molecular-weight heparin 31
Lubricant, water-based 36
Lugol's iodine solution 228, 231
Lumbosacral plexus 11, 13
Lymph node 85
dissection 229
M
Male factor infertility, causes of 154
Mass, abdominal 43, 197
Mastalgia 188
McCune-Albright syndrome 54
Medroxyprogesterone acetate 96
Menarche 47
Menopausal hormone therapy 187, 191, 248
Menopausal phase 182
Menopausal symptoms 57, 60, 184, 192
Menopausal vasomotor 104
Menopause 25, 27, 135, 177, 180, 200
caused by 178
clinical features 182
clinical investigations 178
diagnostic approach 178
genitourinary features of 184
hormonal therapy 187
options 190
risks and benefits of 191
management 178
non-hormonal methods 189
phases 181
physiology of 179
sequelae of 185
surgical 184
symptoms of 29, 177
transition 179
early 183
Menorrhagia 26, 37, 6769, 85, 95, 96, 147
assessment 86
consequence of 68
functional 86
causes and management 86
investigation of 87
management for 89
structural causes and management 88
treatment of 88
Menses 130
breasts without 57
Menstrual cycle 19
disorders of 67, 69
disturbance 69
fraction of 67
management 68
normal 19
number of 67
regular 47
Menstrual history 27
Menstrual period, last 27
Menstrual problems 66
Menstruation 142
Mental health disorders 31
Metabolic complications 82
Metastases 238, 248
Metastatic disease, diaphragms for 248
Metformin 83, 198
Methotrexate 168
Metromenorrhagia 69
Metrorrhagia 69, 77
assessment 77
management 77
Metrostaxis 95, 96
causes of 97
treatment of 96
Mid-line fusion 4
problems 5
Mifepristone 174
Minipill 144
Mirena 145
Miscarriage 31, 165
complete 163
diagnosis of 165
incomplete 163
increased 84
management 166
missed 163
recurrent 31
septic 163
threatened 163
types of 163, 164, 165
Molar pregnancy
complete 169, 170
partial 169, 170
Morbid adhesion formation 122
Müllerian agenesis 58, 59
Müllerian duct 3, 50, 51, 51, 65
abnormalities of 4
formation 66
fusion 65
Müllerian fusion, problems in 65
Müllerian genesis problems 66
Müllerian inhibiting substance 50, 51
Müllerian system, mal-development of 4
Müllerian-inhibiting substance 3
Multi-disciplinary chronic pain 99
Muscle 15
abdominis 15
bones 99
lateral 15
pelvic 10
perineal 9
pyramidalis 15
Musculoskeletal system 109
Mycoplasma 116, 118, 126
genitalium 114, 115
N
Nausea 165
symptoms of 159
Neisseria gonorrhoeae 115
Nerve 16, 99
injury 11
Neurological disease 215
Neurological injury 207
Neurological symptoms 54
Neurological system 109
Nipple discharge 75
No sugar pills 144
Nodal metastases, risk of 229
Nodular tender uterosacral ligaments 105
Non-consensual sex 117
activity 99
Non-hormonal treatment 192
Non-invasive testing 212
Non-sexually acquired infections 124
Non-steroidal anti-inflammatory drugs 90
Non-verbal rapport 26
Norethisterone 96, 188
Nucleic acid amplification test 116, 126
Nystatin 127
O
Obesity 75
Oblique muscles, external and internal 10
Obstructive sleep apnea 82
Obturator nerve 12, 13
Oestradiol 37, 70, 74
patches 70
Oestriol 194
Oestrogen 19, 21, 79, 141, 190, 217
concentrations 47
levels of 19
loss 186
causes 185
pre-menopausal 73
production of 52, 72
Oestrogen-only hormone replacement 240
Office endometrial sampling 40
Oligomenorrhoea 78
cause of 78
Oncology, gynaecological 221
Oocytes 20
Oral anti-acne 83
Oral contraceptive 48, 54, 70, 77, 83, 111
Oral glucose tolerance test 81
Oral isotretinoin 82
Oral progesterone 68, 97
Osteoporosis 186
Ovarian cancer 244
clinical features 245
diagnosis 246
management 248
prognosis 249
subtypes of 244
Ovarian cycle 20, 21
follicular phase 21
luteal phase 22
Ovarian endometriomas 105
Ovarian follicles 79
Ovarian follicular pool 179
Ovarian hyperstimulation
controlled 157
syndrome 159
Ovarian torsion 114
Ovary 85, 166
development of 1
Ovulation induction 156
Ovulatory dysfunction 183
Oxybutynin 217
Oxytrol 217
P
Pain
acute 99
and bleeding 130
Palpable abdominal mass, development of 60
Pap smear 29
Parental pubertal age 54
Pederson speculum 35
Pelvic
anatomy 6
bones 10
cavity, part of 6
lymph node 223, 241
radiation 72
somatic nerves, intrinsic 11
Pelvic floor 9, 9, 10
function 207
injury, causes of 200
muscles 8, 207, 208
surgery 207
Pelvic inflammatory disease 29, 119, 123, 152, 167
clinical features 120
diagnostic approach 120
investigations 122, 123
management 122
types 120
Pelvic nerve 10
parasympathetic 14
Pelvic organ 34, 39
normal 34
ovaries 34
tubes 34
uterus 34
Pelvic organ prolapse 197, 199
clinical features 201
epidemiology 199
investigations 204
management 204
non-surgical treatments 205
pathophysiology 199
quantification system 201
surgical treatments 206
types 199
Pelvic pain 31, 98, 113, 130
causes of chronic 109
disorders 69
treatment of chronic 110
Pelvic ultrasound 44, 243
aids 71
Pelvis 9, 34, 39
contents of lesser 8
greater 9
Perianal skin 11
Peri-menopausal
phase 182
women 67
Perineum 11
Peripheral tissues 59
Peripheral vascular disease 85
Pessary types 205
Pfannenstiel incision 18
Pharynx 116
Pipelle 40
endometrial biopsy 84, 223
Pituitary adenoma 75
Pituitary gland 157
Pituitary-hypothalamic-ovarian axis 98
Placenta accreta 97
Polycystic ovarian morphology 28, 33, 71, 74, 78, 79, 141, 238
Polycystic ovarian syndrome 78, 81
clinical features of 79
history and examination 79
investigations in 80
management 81
pathophysiology 78
pharmacological treatment of 83
Polyenes 127
Polymenorrhoea 95
Polymerase chain reaction 123, 126, 132, 237
Polyps 40, 68
Post-coital bleeding, assessment of 237
Post-menopausal
phase 182
women 205, 219
Post-oophorectomy 246
Post-partum pituitary ischaemic injury 75
Post-termination contraception 173
Pouch of Douglas 120
Pregnancy 67
complication 171
of unknown location 161
strain of 75
Premature gonadal failure 44
Premature puberty 52, 53
differential diagnosis 52
examination 54, 55
history 52
investigations 54
management 55
Pre-menopausal
phase 180
women 248
Pre-menstrual spotting 77
Pre-menstrual syndrome 97
features of 98
Pre-pubertal population 70
Progesterone 19, 21, 37, 141, 142
absence of 184
implant 145
low levels of 98
natural 188
only pill 139, 144
pill, high-dose 150
Progestogen 190
Prolactin 72
Prolactinoma 76, 157
Prolapse
examination 201
signs 202
site 201
stages 201, 203
surgical treatments for 206
symptoms of 202, 205
types of 200, 201
Prostaglandin 101
Proton pump inhibitor therapy 248
Pruritus 130
Pseudo-ephedrine 155
Psychosocial consequences 52
Psychosocial transition 43
Pubertal delay, types of abnormal 58
Pubertal development
normal range of 46
progress of 52
Puberty 43
abnormal 56
disorders of 43, 52
peripheral
precocious 53
premature 52
physiology of normal 45
Pubic hair, minimal 43
Pubic lice 126
Pubic symphysis, inferior margin of 7
Pulmonary embolism 191
Pulmonary hypertension 173
Q
Q-tip test 212
Quadratus lumborum 10
R
Rectal bleeding 222
Rectum 116
Rectus abdominis 10
Recurrent pregnancy loss 170
management 172
pathophysiology 170
Recurrent urinary tract infection 218
diagnosis 218
management 219
pathophysiology 218
Renal disease 30
Reproduction 135
management 136
Reproductive transition, late 100
Rifampicin 143
Rotterdam criteria 80
Ruptured ectopic pregnancy 36, 114, 161, 167
S
Saline hysterography 40
Saline infusion 41
Salpingostomy 168
Sarcoma 242
Scars, surgical 34
Sciatic nerve 12
Scrotal incisions 149
Semen analysis 135, 155
Septum, vertical 51
Serum oestrogen 47
Sex cord-stromal tumours 246
Sex steroids 37
Sexual function 26
Sexual hair growth 45
Sexual history, part of 30
Sexual intercourse 115
Sexual pain 26
Sexual problems 66
Sexually transmitted infection 29, 87, 115, 118, 123, 126, 237
clinical features 117
common 118
diagnostic approach 117
epidemiology 116
investigations in 123
pathophysiology 116
principles of management 119
types 116
Sheehan syndrome 75
Shock, hypotensive 75
Sinovaginal bulb 51
Six-pack appearance 15
Skin 47, 79
injury to 99
Solifenacin 217
Somatic nerves 11
Speculum 34
bivalve 35
examination 32, 34
Sims 35
types of 34, 35
Sperm abnormalities 154
Spironolactone 83
Spotting 236
Squamous intra-epithelial lesion
high-grade 234
low-grade 234
Stress
incontinence 209
levels of 43
ulceration 248
Stress incontinence management 215
conservative therapies 216
medical therapies 216
surgical therapies 218
Stroke, myocardial infarction 97
Structural causes 65
Sub-mucous fibroids 152
Swyer syndrome 61, 62, 64
Syphilis 115, 140
Systemic symptoms, treatment of 187
T
Tachycardia 86
Tanner staging 49
Tendons 99
Termination of pregnancy 172
counselling 173
management 174
medical 174
pathophysiology 173
surgical 174
Testosterone 80
exogenous 155
Tetracycline antibiotics 83
Thelarche 47, 54
menarche 45
Therapeutic indwelling catheter 198
Thyroid 89
function tests 87
Thyroxine, free 76
Tolterodine 217
Topical anti-acne 83
Topical oestriol 194
Tranexamic acid 67, 96
Transvaginal ultrasound 39
Transverse septum 51
Trichomonas 116, 118, 126
infects 116
vaginalis 115
Trophoblastic hyperplasia 169
Tubal ligation 148, 152
with filshie clips 149
with pomeroy procedure 149
Tubal occlusion 153
Tubo-ovarian abscess 114
Tumour 54
advanced stage 248
early-stage 229, 248
gynaecological 38
mucinous 246
Turner syndrome 57, 61, 62, 64, 72
U
Ulipristal acetate 150
Undescended testes 57
Urea
and creatinine 76, 123
electrolytes 160
Urethra 116, 186, 198, 208
contraction 207
sphincter, internal 207
Urge incontinence 216, 217
management 215
conservative therapies 215
medical therapies 215
Urinary dysfunction 197
Urinary frequency 121
Urinary hygiene 219
Urinary incontinence 207
epidemiology 209
history 209
normal continence 207
pathophysiology 209
Urinary luteinising hormone 152
Urinary sepsis 121
Urinary sphincter tone 217
Urinary tract infection 198
Urinary urgency 216
management of 215
pharmacological therapy for 217
Urine 123
mid-stream specimen of 204
Urodynamics 213
Urogenital sinus 50
fusion 66
Urological system 109
Uterine 153
agenesis 59
anatomy 17
anomalies 40
cancers 238
types of 240
cavity 145
contractions 24
diagnosis of 154
enlargement 66
perforations 92
prostaglandin production 48
synechiae 40
Uterine muscle cancers 242, 243
clinical features 242
diagnosis 243
management 244
Uterine sarcoma 39
risk factor for 243
Uterus 3, 17, 50, 51, 86, 100, 116, 242
enlarged 57
formation of 51
relations of 17
V
Vagina 51, 113, 116
developing 51
formation of 51
upper 3, 50
Vaginal bleeding 165
Vaginal cancer 226228
Vaginal dilator, long-term 242
Vaginal discharge 26
Vaginal dysplasia 227, 228
Vaginal fourchette, posterior 36
Vaginal hydrators 194
Vaginal hysterectomy 93
Vaginal mucosa 205
Vaginal oestradiol 194
Vaginal oestrogen
consists of 216
therapy, role for 215
Vaginal ring (NuvaRing) 139, 143, 144
Vaginal septum, transverse 5
Vascular system 109
Vasectomy 149
Vasomotor symptom 180, 183, 193
cause of 191
Venlafaxine 192, 193
Venous thromboembolism 92, 140, 191
Verbal rapport 26
Vertical fusion 5
problems 5
Visceral pain 14
Vital signs 33
Vitamin E 193
Vomiting 165
von Willebrand disease 87
Vulva 113, 226
Vulval cancer 226, 228, 230
Vulval dysplasia 228
Vulval neoplasia 126, 127, 132
Vulvar dermatoses 129
Vulvodynia 99
Vulvoscopy 127
Vulvovaginal irritation, mild 128
Vulvovaginitis 126
W
Warfarin 31
White blood cell count 123
Wolffian duct 3, 50, 51, 51
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Chapter Notes

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Gynaecology
Gynaecology
Jodi Keane BPhysio (Hons) MBBS (Hons) FRANZCOG MHA (Dist) CCPU Consultant Obstetrician and Gynaecologist Monash Health Assessment Coordinator (Women's Health) Monash University Victoria, Australia Manda Raz MBBS (Hons) Resident Medical Officer Monash Health Victoria, Australia Shavi Fernando MBBS (Hons) BMedSc (Hons) FRANZCOG PhD Consultant Obstetrician and Gynaecologist Monash Health Director of Undergraduate Curriculum (Women's Health) School of Clinical Sciences Curriculum and Assessment Lead (Women's Health) Monash University Victoria, Australia
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9781787791237
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A catalog record for this book is available from the Library of Congress
Development Editor:
Harsha Madan
Editorial Assistant:
Keshav Kumar
Cover Design:
Seema Dogra
Preface
It is an undisputed fact that half of the population are female.
It is also hard to dispute that prepubertal girls, adolescents, adult cycling women, pre- and post-menopausal women all have gynaecological needs.
These needs are not always well met. Furthermore, the common clinical presentations, physiological underpinnings and management are often difficult to grasp, leading to poor understanding and fear in the junior clinician-fear of examining appropriately, fear of making the correct diagnosis and fear of managing relatively simple problems.
This leads to poorer outcomes.
Even in resource rich nations, women suffer the consequences of overly heavy menstruation, significant morbidity or mortality from unwanted or ectopic pregnancy and pain from treatable gynaecologic conditions that is diagnosed late or not at all. This needs to change.
Pocket Tutor Gynaecology provides an approachable, concise but comprehensive guide to the subject that is practical, straightforward and designed to give you, the clinician, pocket-sized access to confidence in appropriately assessing, diagnosing and treating common gynaecological presentations. It is intended for those who wish to include regular gynaecological care in their future practise but also for the general student and junior doctor who needs a refresh before a clinical encounter.
Clinical essentials and first principles chapters systematically outline key principles and anatomy and physiology, and the gynaecological lifespan is outlined in detailed chapters covering puberty, menstrual disorders, reproduction, and the menopause transition. There are also dedicated chapters covering common consequences of genital diseases, as well as childbearing, prolapse and incontinence and of gynaecological cancers.
Throughout the book we have included practical tips, useful diagrams and clinical images, examination techniques and tips as well as management options and their theoretical underpinnings to aid the junior clinician. We also emphasise woman-centred and sensitive clinical care.
We hope Pocket Tutor Gynaecology provides you with a solid grounding on your journey in the field of gynaecology, regardless of your final destination. Whether you are a medical student or a junior doctor, Pocket Tutor Gynaecology is your portable guide to understanding concepts, passing exams and providing clinical care during your gynaecology term.
Jodi Keane
Shavi Fernando
Manda Raz
November 2021
Acknowledgements
Yet again I find myself grateful to work with passionate and skilled co-authors on a project, this has made a mountain of a task a remarkably feasible undertaking and one of which we are all very proud. My family continue to grow, thrive and these days prefer electronic devices to children's television. Lily, Gemma and Rosie, thank you for your patience with an old-fashioned book. Sir Chas remains the best Sir I know from a field of one and absolutely a knight in shining school-run armour.
JK
Thanks to my co-authors, mentors, colleagues and patients, who continue to inspire me to pursue excellence.
MR
Thanks to my co-authors for their hard work and persistence. Thanks to my wife Sharmayne and children, Ellara and Arlen, who have allowed me extra time on top of a busy schedule to complete this book.
SF