Problems in Gynaecology
There is ample opportunity and scope for gynaecology in prim ary care in general practice. Many conditions and problems can be managed successfully in this context without referral to hos pital and specialist care. The first aim of this book is to deal with common problems that are referred for consultant opinion and specialist management to the average District General Hospital by analysing problems of presentation and diagnosis on a symptom-orientated basis. Selection for primary care management as opposed to hospital referral is then considered, following which the wide range of available treatment is evaluated with particular emphasis on the maximum use of up-to-date but proven regimes. The full use of the expertise of the practitioner is highlighted throughout. The second aim is to encourage the practice of primary care gynaecology and to help those doctors who have a special in terest in the subject, while hopefully stimulating others to de velop a similar one. With this in mind, the approach to the problems is realistic and often dogmatic while opportunities for individual management and for practical procedures are kept to the forefront.
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abdominal acute assessment associated atrophic vaginitis backache bacteriuria bladder bleeding breast candidiasis carcinoma cause cervical chronic pelvic inflammatory clinical coitus condition contraceptive course cream cycle cyst detect detrusor diagnosis dilator dosage dose dysfunctional dysmenorrhoea dyspareunia dysuria effective endometriosis examination factors failure fistula Gardnerella genital tract give rise given glands gonococcal gynaecological haemorrhage hormonal therapy hospital referral hourly important initial investigation lesion mass menorrhagia menstrual metronidazole micturition normal occur oestrogen onset oral organisms ovarian pain palpation particularly patient pelvic disease pelvic inflammatory disease pessary polyp possible posterior Pouch of Douglas pregnancy present primary physician problem procedure produce progestogen prolapse psychosomatic purulent rare rectal recurrence renal result retention secondary sexual side-effects signs speculum stress incontinence surgical swab swelling tion treatment trichomonad tumour ulceration urethral syndrome urge incontinence urinary infection urinary symptoms urine usually uterine uterus vaginal discharge vaginal introitus vaginal wall vulva woman women