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Female Urology
Urogynecology or urogynaecology is a surgical sub-specialty of urology and gynecology. History In 1893, Howard Atwood Kelly, Howard Kelly, a gynecologist and pioneering urogynecologist, invented an air cystoscope which was simply a handheld, hollow tube with a glass partition. When the American Surgical Society, later the American College of Surgeons, met in Baltimore in 1900, a contest was held between Howard Atwood Kelly, Howard Kelly and Hugh H. Young, Hugh Hampton Young, who is often considered the father of modern urology. Using his air cystoscope, Kelly inserted ureteral catheters in a female patient in just 3 minutes. Young equaled this time in a male patient.Hugh H. Young, Young HH. A Surgeon's Autobiography. New York: Harcourt, 1940. So began the friendly competitive rivalry between gynecologists and urologists in the area of female urology and urogynecology. This friendly competition continued for decades. In modern times, the mutual interest of obstetricians, gynecologis ...
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Gynecology
Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the Female reproductive system, female reproductive system. It is often paired with the field of obstetrics, which focuses on pregnancy and childbirth, thereby forming the combined area of obstetrics and gynaecology (OB-GYN). Gynaecology encompasses both Primary care, primary and Preventive healthcare, preventative care of issues related to female reproduction and sexual health, such as the uterus, vagina, fallopian tubes, ovaries, and breasts; subspecialties include family planning; minimally invasive surgery; pediatric and adolescent gynecology; and pelvic medicine and reconstructive surgery. While gynaecology has traditionally centered on Cisgender, cisgender women, it increasingly encompasses anyone with female organs, including transgender, intersex, and Non-binary gender, nonbinary individuals; however, many non-cis women face acce ...
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Hugh H
Hugh is the English-language variant of the masculine given name , itself the Old French variant of '' Hugo (name)">Hugo'', a short form of Continental Germanic Germanic name">given names beginning in the element "mind, spirit" (Old English ). The Germanic name is on record beginning in the 8th century, in variants ''Chugo, Hugo, Huc, Ucho, Ugu, Uogo, Ogo, Ougo,'' etc. The name's popularity in the Middle Ages ultimately derives from its use by Frankish nobility, beginning with Duke of the Franks and Count of Paris Hugh the Great (898–956). The Old French form was adopted into English from the Norman period (e.g. Hugh of Montgomery, 2nd Earl of Shrewsbury d. 1098; Hugh d'Avranches, 1st Earl of Chester, d. 1101). The spelling ''Hugh'' in English is from the Picard variant spelling '' Hughes'', where the orthography ''-gh-'' takes the role of ''-gu-'' in standard French, i.e. to express the phoneme /g/ as opposed to the affricate /ʒ/ taken by the grapheme ''g'' before fron ...
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Müllerian Agenesis
Müllerian may refer to: * Müllerian mimicry, a type of mimicry or convergence named after Fritz Müller * Müllerian ducts, which enter the cloaca of an embryo (named after Johannes Peter Müller) * Mullerian anomalies are structural anomalies caused by errors in embryonic müllerian duct development * Mixed Müllerian tumor {{Disambiguation ...
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Lichen Sclerosus
Lichen sclerosus (LS) is a chronic, inflammatory skin disease, of unknown cause, which can affect any body part of any person, but has a strong preference for the genitals (penis, vulva), and is also known as balanitis xerotica obliterans when it affects the penis. Lichen sclerosus is not contagious. There is a well-documented increase of skin cancer risk in LS, potentially improvable with treatment. LS in adult age women is normally incurable, although treatment can lessen its effects, and it often gets progressively worse if not treated properly. Most males with mild or intermediate disease, restricted to foreskin or glans, can be cured by either medical or surgical treatment. Signs and symptoms LS can occur without symptoms. White patches on the LS body area, itching, pain, dyspareunia (in genital LS), easier bruising, cracking, tearing and peeling, as well as hyperkeratosis, are common symptoms in both men and women. In women, the condition most commonly occurs on the vul ...
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Lichen Planus
Lichen planus (LP) is a chronic inflammatory and autoimmune disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, but is named for its appearance. It is characterized by polygonal, flat-topped, violaceous papules and plaques with overlying, reticulated, fine white scale (Wickham striae, Wickham's striae), commonly affecting dorsal hands, flexural wrists and forearms, trunk, anterior lower legs and oral mucosa. The hue may be gray-brown in people with darker skin. Although there is a broad clinical range of LP manifestations, the skin and oral cavity remain as the major sites of involvement. The cause is unknown, but it is thought to be the result of an autoimmune process with an unknown initial trigger. There is no cure, but many different medications and procedures have been used in efforts to control the symptoms. The term lichenoid reaction (lichenoid eruption or lichenoid lesion) refers to a lesion of similar or identical histopathology, ...
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Interstitial Cystitis
Interstitial cystitis (IC), a type of bladder pain syndrome (BPS), is chronic pain in the Urinary bladder, bladder and pelvic floor of unknown cause. Symptoms include urinary urgency, feeling the need to urinate right away, urinary frequency, needing to urinate often, bladder pain (pain in the organ) and pain with sex. IC/BPS is associated with depression (mood), depression and lower quality of life. Some of those affected also have irritable bowel syndrome and fibromyalgia. The cause of interstitial cystitis is unknown. While it can, it does not typically run in a family. The diagnosis is usually based on the symptoms diagnosis of exclusion, after ruling out other conditions. Typically the urine culture is negative. Ulceration or inflammation may be seen on cystoscopy. Other conditions which can produce similar symptoms include overactive bladder syndrome, overactive bladder, urinary tract infection (UTI), sexually transmitted infections, prostatitis, endometriosis in females ...
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Urinary Incontinence
Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a significant effect on quality of life. Urinary incontinence is common in older women and has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting). UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others. Pelvic surgery, pregnancy, childbirth, attention deficit disorder (ADHD), and menopause are major risk factors. Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners. There are four main types of incontinence: * Urge incontinence ...
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Fecal Incontinence
Fecal incontinence (FI), or in some forms, encopresis, is a lack of control over defecation, leading to involuntary loss of bowel contents—including flatus (gas), liquid stool elements and mucus, or solid feces. FI is a sign or a symptom, not a diagnosis. Incontinence can result from different causes and might occur with either constipation or diarrhea. Continence is maintained by several interrelated factors, including the anal sampling mechanism, and incontinence usually results from a deficiency of multiple mechanisms. The most common causes are thought to be immediate or delayed damage from childbirth, complications from prior anorectal surgery (especially involving the anal sphincters or hemorrhoidal vascular cushions), altered bowel habits (e.g., caused by irritable bowel syndrome, Crohn's disease, ulcerative colitis, food intolerance, or constipation with overflow incontinence). Reported prevalence figures vary: an estimated 2.2% of community-dwelling adult ...
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Female Genital Prolapse
Pelvic organ prolapse (POP) is characterized by descent of pelvic organs from their normal positions into the vagina. In women, the condition usually occurs when the pelvic floor collapses after gynecological cancer treatment, childbirth or heavy lifting. Injury incurred to fascia membranes and other connective structures can result in cystocele, rectocele or both. Treatment can involve dietary and lifestyle changes, physical therapy, or surgery. Types * Anterior vaginal wall prolapse ** Cystocele (bladder into vagina) ** Urethrocele (urethra into vagina) ** Cystourethrocele (both bladder and urethra) * Posterior vaginal wall prolapse ** Enterocele (small intestine into vagina) ** Rectocele (rectum into vagina) ** Sigmoidocele * Apical vaginal prolapse ** Uterine prolapse (uterus into vagina) ** Vaginal vault prolapse (descent of the roof of vagina) – after surgical removal of the uterus hysterectomy Grading Pelvic organ prolapses are graded either via the Baden–W ...
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Enterocele
An enterocele is a herniation of a peritoneum-lined sac containing small intestine through the pelvic floor, between the rectum and the vagina (in females). Enterocele is significantly more common in females, especially after hysterectomy. It has been suggested that the terms enterocele and sigmoidocele are inaccurate, since hernias are usually named according to location and not according to contents. However, the terms are in widespread use. As such, enterocele, peritoneocele, sigmoidocele, and omentocele could be considered as types of cul-de-sac hernia. Classification * Posterior enterocele (develops in the rectovaginal space, also termed the pouch of Douglas or the cul-de-sac). * Anterior enterocele (develops in the vesicovaginal space). ** Retains the full thickness of the anterior vaginal wall. ** Lacks vaginal wall (or very thin and ulcerated vaginal wall). Anterior enterocele is rare. It may occur after cystectomy or hysterectomy. In these cases, the anterior wall of ...
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Cystocele
A cystocele, also known as a prolapsed bladder, is a medical condition in which a woman's bladder bulges into her vagina. Some may have no symptoms. Others may have trouble starting urination, urinary incontinence, or frequent urination. Complications may include recurrent urinary tract infections and urinary retention. Cystocele and a prolapsed urethra often occur together and is called a cystourethrocele. Cystocele can negatively affect quality of life. Causes include childbirth, constipation, chronic cough, heavy lifting, hysterectomy, genetics, and being overweight. The underlying mechanism involves weakening of muscles and connective tissue between the bladder and vagina. Diagnosis is often based on symptoms and examination. If the cystocele causes few symptoms, avoiding heavy lifting or straining may be all that is recommended. In those with more significant symptoms a vaginal pessary, pelvic muscle exercises, or surgery may be recommended. The type of surgery typical ...
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Pelvic Organ Prolapse Quantification System
The Pelvic Organ Prolapse Quantifications System (POP-Q) is a system for assessing the degree of prolapse of pelvic organs to help standardize diagnosing, comparing, documenting, and sharing of clinical findings. This assessment is the most frequently used among research publications related to pelvic organ prolapse. When assessed using the POP-Q, the prevalence of pelvic organ prolapse is estimated to be up to 50% while diagnosis by symptoms has a prevalence of 3–6%. Some advocate that the system of assessment be modified. The POP-Q was developed in 1996, it quantifies the descent of pelvic organs into the vagina. The POP-Q provides reliable description of the support of the anterior, posterior and apical vaginal wall. It uses objective and precise distance measurements to the reference point, the hymen. Cystocele and prolapse of the vagina from other causes is staged using POP-Q criteria and can range from good support (no descent into the vagina) reported as a POP-Q stage 0 ...
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