Gynecology

GynecologyGynecology

The Study of the Female The Study of the Female Reproductive SystemReproductive System

““Gynecology”Gynecology”

• from the Greek, from the Greek, gynaikos gyno- gynaikos gyno- pertaining to woman pertaining to woman

• -logy, meaning study of-logy, meaning study of

• Thus, gynecology Thus, gynecology literally is the “study of literally is the “study of women” women”

• modern gynecology modern gynecology focuses on disorders of focuses on disorders of the female reproductive the female reproductive organs organs

What is gynecology?What is gynecology?• The medical The medical

specialty specialty concerned with the concerned with the female female reproductive reproductive organsorgans

– External genitaliaExternal genitalia• VulvaVulva

– Labia majora, labia Labia majora, labia minora, and clitorisminora, and clitoris

– Internal genitaliaInternal genitalia• UterusUterus• OvariesOvaries• Fallopian tubesFallopian tubes• VaginaVagina

– Extends to the Extends to the external surface of external surface of the bodythe body

Some history…Some history…• The historic taboo The historic taboo

associated with the associated with the examination of female examination of female genitalia has inhibited genitalia has inhibited the science of the science of gynecology gynecology

• This 1822 drawing by This 1822 drawing by Jacques-Pierre Maygnier Jacques-Pierre Maygnier shows a "compromise" shows a "compromise" procedure, in which the procedure, in which the physician is kneeling physician is kneeling before the woman but before the woman but cannot see her genitalia cannot see her genitalia

• Modern gynecology has Modern gynecology has shed most of these shed most of these inhibitions…but there is inhibitions…but there is still a lot to learn! still a lot to learn!

It’s all Greek to me…It’s all Greek to me…

• Dated from 1800 BCE, The Kahun Gynaecological Papyrus is the Dated from 1800 BCE, The Kahun Gynaecological Papyrus is the oldest known medical text reporting gynecological concerns, such oldest known medical text reporting gynecological concerns, such as fertility, pregnancy, contraception etc. as fertility, pregnancy, contraception etc. – Each section deals with a specific problem and contains diagnosis and Each section deals with a specific problem and contains diagnosis and

treatment, but, no prognosis is suggested treatment, but, no prognosis is suggested – treatments are non surgical, suggesting applying medicines to the treatments are non surgical, suggesting applying medicines to the

affected body part or swallowing themaffected body part or swallowing them– The womb is at times seen as the source of complaints manifesting The womb is at times seen as the source of complaints manifesting

themselves in other body partsthemselves in other body parts• According to the Suda, the ancient Greek physician Soranus of According to the Suda, the ancient Greek physician Soranus of

Ephesus practiced gynecology in Alexandria and RomeEphesus practiced gynecology in Alexandria and Rome– treatise treatise GynaikeiaGynaikeia

• J. Marion Sims is considered the father of American J. Marion Sims is considered the father of American • gynecologygynecology

– Learned to repair vesicovaginal fistulas Learned to repair vesicovaginal fistulas – Used experimental procedures on slavesUsed experimental procedures on slaves

Sim’s speculum

Focus on the fallopian tubeFocus on the fallopian tube

• The falloian tube transports the ovum from The falloian tube transports the ovum from the ovaries to the uterusthe ovaries to the uterus– Finger like projections called fimbriae expand Finger like projections called fimbriae expand

from the tubes from the tubes – Fimbriae catch and guide the ovum from the Fimbriae catch and guide the ovum from the

ovaries after ovulationovaries after ovulation– Small hair-like projections called cilia on the cells Small hair-like projections called cilia on the cells

of the fallopian tube lining propel the ovum of the fallopian tube lining propel the ovum through the tube to the uterusthrough the tube to the uterus

– Fertilization, where the sperm meets the egg, Fertilization, where the sperm meets the egg, usually occurs in the upper half of the fallopian usually occurs in the upper half of the fallopian tubetube

What’s in a name?What’s in a name?• Also referred to as uterine Also referred to as uterine

tubes or oviductstubes or oviducts• Named fallopian for Gabriele Named fallopian for Gabriele

Falloppio Falloppio – 16th-century Italian physician 16th-century Italian physician

and surgeon who was an and surgeon who was an expert in anatomy, physiology expert in anatomy, physiology and pharmacologyand pharmacology

– Considered an early expert on Considered an early expert on syphilis, one of the great syphilis, one of the great surgeons of the age, and often surgeons of the age, and often seen as a hero of anatomy seen as a hero of anatomy

– "Observationes anatomicae", a "Observationes anatomicae", a work of great originality, work of great originality, contributed to the contributed to the understanding of: understanding of:

• centers of ossificationcenters of ossification• detailed account of musclesdetailed account of muscles• the vascular system and the the vascular system and the

kidneyskidneys– Falloppio’s description of the Falloppio’s description of the

uterine tubes were sufficiently uterine tubes were sufficiently accurate and thus, bear his accurate and thus, bear his namename

fertilization

fallopian tube

Supercalafragilistic Supercalafragilistic expialadocious expialadocious

• Total abdominal hysterectomy-bilateral Total abdominal hysterectomy-bilateral salpingo-oophorectomy…the longest term salpingo-oophorectomy…the longest term in medical history!in medical history!

• Refers to the removal of the uterus, cervix, Refers to the removal of the uterus, cervix, ovaries, and fallopian tubesovaries, and fallopian tubes

• Procedure is used when cancer is present Procedure is used when cancer is present in the uterus and has spread to other in the uterus and has spread to other organs or tissues in the reproductive organs or tissues in the reproductive systemsystem

TAH/BSOTAH/BSO

• Procedure includes 3 surgeries:Procedure includes 3 surgeries:– TAH:TAH: Total abdominal hysterectomyTotal abdominal hysterectomy

•removal of uterus and cervixremoval of uterus and cervix

– BSO:BSO: Bilateral salpingo-oophorectomyBilateral salpingo-oophorectomy•Removal of fallopian tubes and ovariesRemoval of fallopian tubes and ovaries

– Pelvic node dissectionPelvic node dissection •removal of lymph nodes in pelvisremoval of lymph nodes in pelvis

Check out this book on the procedure, recovery and other resources:

resources citedresources cited

• biology.clc.edubiology.clc.edu• Fremgen, Bonnie F. & Frucht, Suzanne Fremgen, Bonnie F. & Frucht, Suzanne

S. S. Medical Terminology: A Living Medical Terminology: A Living Language: 3e.Language: 3e. New Jersey: Pearson New Jersey: Pearson Education. 2005Education. 2005

• hhsc.cahhsc.ca• medterms.commedterms.com• revolutionhealth.comrevolutionhealth.com• wikipedia.orgwikipedia.org