Archive for August, 2007

Vulvar Disorders Among Children And Adolescents

Friday, August 17th, 2007

It may be difficult for a young child to describe vulvar sensations. Parents may notice the child crying during urination, scratching herself repeatedly, or complaining of vague symptoms. Often, the gynecologic child patient’s pediatrician will have evaluated the child for urinary tract infection. Evaluation for pinworms is also warranted, as pinworms can cause severe itching in the vulvar as well as perianal area. Vulvovaginitis is the most common gynecologic problem of childhood. Prepubertally, the vulva, vestibule, and vagina are anatomically and histologically vulnerable to infection. The physical proximity of the vagina and vestibule to the anus can result in overgrowth of pathogenic bacteria that can cause primary vulvitis and secondary vaginitis. Cultures of these bacteria can be seen and studied using medical microscopes such as a gynecology microscope. (more…)

Ovarian Masses

Friday, August 17th, 2007

Women, during their postmenopausal years, have ovaries that gradually decrease in size. With the use of a gynecology microscope, the dimensions of ovaries before menopause are approximately 3.5 X 2 X 1.5 cm. In early menopause, the ovaries are approximately 2 X 1.5 X 0.5 cm. In late menopause, they are even smaller: 1.5 X 0.75 X 0.5 cm. (more…)

Diagnosis and Management of Pelvic Mass in Adolescents

Friday, August 17th, 2007

In adolescent gynecologic patients, pregnancy should always be considered as a cause of a pelvic mass. In the U.S., more than 50% of adolescent young women have experienced sexual intercourse by 17 years of age. More than 85% of pregnancies among adolescents are unintended. Adolescents may be more likely than adults to deny the possibility of pregnancy be¬cause of wishful thinking, anxiety about discovery by parents or peers, or unfamiliarity with menstrual cycles and information about fertility. Ectopic pregnancies may present with pelvic pain and an adnexal mass. With the availability of quantitative measurements of 13-human chorionic gonadotropin (hCG), more ectopic pregnancies are being discovered before rupture, allowing conservative management with laparoscopic surgery or medical therapy with Methotrexate. The risk of ectopic pregnancy varies by method of contraception: users of no contraception have the highest risk, whereas oral contracep¬tive users have the lowest risk. As in older patients, paraovarian cysts and non-gyne¬cologic masses may be discovered in adolescents with the use of medical microscopes such as a gynecologic microscope. (more…)

Acute Bleeding: Emergency Management

Friday, August 17th, 2007

The decision to hospitalize a gynecologic patient depends on the rate of current bleeding and the severity of any existing anemia. The actual acute blood loss may not adequately be re¬flected in the initial blood count but will be revealed with serial hemoglobin assess¬ments with the use of medical microscopes. The cause of acute menorrhagia may be a primary coagulation disorder, so measurements of coagulation and hemostasis, including bleeding time, should be performed for any adolescent gynecologic patients with acute menorrhagia. Von Willebrand’s disease, platelet disorders, or hematologic malignancies (diagnosed with a gynecology microscope) can all present with menorrhagia. De¬pending on the gynecologic patient’s level of hemodynamic stability or compromise, a blood sample can be analyzed for type and screen. The decision to transfuse must be considered care¬fully, and the benefits and risks should be discussed with the adolescent and her parents. Generally, there is no need for transfusion unless the gynecologic patient is hemodynamically unstable. (more…)

Understanding Neoplasia and Endometrial Hyperplasia

Friday, August 17th, 2007

Women are susceptible to a variety of gynecologic disorders and malignancies. Gynecology microscopes help gynecologists in assessing and diagnosing these gynecological problems. (more…)