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Gynecology

• Editor's Note
• List of Articles

List of Articles

• Sexually Transmitted Diseases
  Sexually transmitted diseases (STDs) represent a prevalent and compelling problem for women. As such, healthcare providers need to take a proactive approach in identifying vaginal symptoms, diagnosing infections, treating these conditions effectively, and maintaining careful follow-up with patients to help reduce the risk of recurrence or re-exposure. We hope that these materials provide valuable information and ideas that can be used to enhance the everyday care of the patients. Clinicians treating female adolescents should be prepared to offer confidential and comprehensive counseling, screening, and treatment according to established guidelines. They should also work within their communities and at the state and national levels to ensure access to medical care for all adolescents. Most importantly, clinicians can help to address this problem when caring for adolescent patients. Specifically, when providing health care for adolescents who have not yet become sexually active, abstinence from all risky behaviors should be encouraged.
  
  
• Diagnosis of Vaginitis & Pelvic Inflammatory Disease
  Vaginal infections represent an enormous, yet often underestimated element of female healthcare. Each year millions of women report symptoms of vaginitis to their clinician. Vaginitis can create a great deal of discomfort, stress, and anxiety in patients; furthermore these conditions may exert untoward and long-term effects on well-being, reproductivity and even mortality. The success with which vaginitis is managed depends largely on the counseling methods used by the healthcare provider. The purpose of this document is to understand three most common vaginal infections: bacterial vaginosis; candida vaginitis (yeast); and trichomonas vaginitis. Pelvic inflammatory disease (PID) and its management are also discussed to understand its causes and appropriate treatment. Vaginal infections can raise very serious concerns for patients. The manner in which women respond to the information about their infection, and how well they succeed with practices to treat it and prevent recurrences, depends largely on their healthcare provider's counseling methods.
  
  
• Toxic Shock Syndrome
  Toxic shock syndrome (TSS) was first described in children in 1978 but was quickly identified as an illness occurring primarily in menstruating women 12-24 years of age. During the 1979-1981 epidemic, tampon users were demonstrated to be 18 times more likely to develop menstrual TSS than non-users. Recent focus has shifted in conjunction with wound infections, postpartum endometritis and vaginitis; the predominance of cases continues to be related to menstruation. The purpose of this document is to understand the pathogenesis of toxic shock syndrome (TSS), clinical picture, early diagnosis and the latest advances in treatment. Of the approximately 30 million menstruating women in USA, it is estimated that 70% use tampons and over 50% of those use super-absorbent types. Almost 1,000,000 women are at theoretic risk. The incidence in menstruating women is now 6-7: 100,000 annually. The incidence on non-menstrual disease has shown only a slight increase in the past 10 years.
  
  
• Endometriosis
  Endometriosis is the presence of tissue that resembles normal endometrium at site outside of the uterus. The anatomical areas most commonly affected by endometriosis are the ovaries, the pelvic peritoneum, the uterosacral ligaments, the fallopian tubes, the appendix and the bowel serosa. Endometriomas, or "chocolate cysts" are cysts of endometriosis within the ovary. The "gold standard" for diagnosing endometriosis is laparoscopy, with visual recognition of endometriosis lesions. The severity of endometriosis is defined by the American Society for Reproductive Medicine using a surgical staging system based on the size and location of endometriosis implants and the severity of pelvic scarring. The stages are: Stage I-minimal, Stage II-mild, Stage III-moderate and Stage IV-severe.
  
  

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