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The Gynecologist's Perspective

The eChapter begins by introducing a gynecological assessment methodology that is thorough, easy to understand and simple to apply in clinical practice. Starting with the presenting complaint, the author emphasizes the need to track back to the time of suspected onset, be it puberty, onset of menopause, incidence of first intercourse, surgery or even an episode of exceptional emotional stress, and what specifically about this complaint is disturbing the patient at the time of consultation. Detailed examples of this approach are described, including candidiasis and it’s relationship to puberty, atrophic vaginitis to ovarian failure, vulvar dermatoses to psychosexual disturbances, inflammatory disorders to fissure development and so on.

The author then progresses to consider the importance of the related history, and stresses the need to incorporate parity, gravidity, mode of contraception, fertility requirements and a detailed menstrual history into the assessment. Once again, practical examples are given to illustrate the process, including the relationship between lactation and atrophic vaginitis, depression and infertility, and the importance of identifying intercurrent diseases such as vulvar psoriasis and extragenital lesions.

The importance of identifying any topical treatment history is emphasised, as are systemic therapies such as HRT and contraception, and their relevance to diagnosis. The eChapter also describes in detail methods of physical examination, including appropriate positioning, the placement of hands, dealing with menstrual discharge, and the use of the Sims’ speculum, colposcopy, and the loupe. How to perform a Wright’s stain to identify host cell and microorganism morphology is described in detail, and normal, atrophic, infected and eroded slides are described with the support of color illustrations.

This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vagina Manual is an invaluable resource especially suitable for:

  • Gynecologists
  • Dermatologists
  • General Practitioners
  • Obstetricians
  • Midwives
  • General nurses
  • Practice nurses
  • Nurse Practitioners

There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.

Contents include

  • Clinical assessment of lower female genital tract complaints
  • Collating a comprehensive history, including the importance of including the use of topical treatments and systemic therapies
  • Interpreting the presenting complaint: tracking back to the origin of the problem
  • Tools to aide examination of the vulva, including the use of Sims’ speculum, the colposcope and magnifying loupe’s
  • The use of local microscopy, how to perform a correct Wright’s stain, and the interpretation of findings.
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Author / Editor Biographies

John Brenan is a dermatologist practicing in Melbourne. He is a past President of the Australian College of Dermatology, consultant dermatologist to the Mercy Hospital for Women and the original dermatologist for the Dermogynaecology Clinic.
David Allen is a certified gynaecological oncologist practicing at the Mercy Hospital for Women and the Peter MacCallum Cancer Centre, East Melbourne. He is an Associate Professor in the Department of Surgery at the University of Melbourne.
James Scurry is one of Australia's leading gynaecological pathologists. He is a pathologist in Newcastle, New South Wales.
Dr Dennerstein is an Obstetrician and Gynaecologist with medical expertise in the health of the vulva and vagina. He is the former Head of the Dermo-gynaecology Clinic at The Mercy Hospital for Women and co-author of the book entitled: The Vulva and Vagina Manual. He has lectured extensively on this topic, both internationally and nationally. Graeme has extensive experience in family planning and reproductive health. In 1971 he established the Family Planning and Infertility Clinic at the Western General Hospital in Melbourne, serving as its director until 1986. From 1980 to 1989 he was the ...
Grazia Marin is a psychologist in private practice in Melbourne and past committee member and Education Officer of the Victorian Psychosexual Society. She is also a member of the International Society for the Study of Vulvovaginal Diseases and is serving on its Patient Education and Sexual Difficulties committees.

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