Multiple diagnoses and procedures during hysterectomy.

Seldom does a gynecologic patient, who needs a hysterectomy, have a single diagnosis. Among 2892 gynecologic patients who needed a hysterectomy, only 127 had a single diagnosis. The rest had two to ten separate diagnoses.

Diastasis recti and umbilical hernia causes, recognition and repair.

Unlabelled: Among 1738 parous women who needed abdominal hysterectomies, 553 were found to have mild, 108 had moderate, and 12 had severe diastasis recti. Also, 97 had umbilical hernias. Methods of recognition and repair are diagramed and discussed.

Decreasing numbers of patients for vaginal hysterectomy and plasty.

Among 2904 patients who needed hysterectomy, the numbers of patients who needed vaginal hysterectomy and plasty have decreased steadily during the 40 years, 1948-88, although indications have remained constant. There has been a steady reduction in the severity and numbers of patients with uterine sagging. Likewise, there has been a notable decrease in the severity of, and numbers of, patients with old perineal lacerations.

Volume reduction of the uterus during and soon after hysterectomy.

Gynecologists observe perceptible and variable reduction from uterine size in vivo to subsequent size in the pathology laboratory. To measure this decrease in uterine size, the thickness, breadth, and height of the corpus were measured four times: as soon as the abdomen had been opened, as soon as the uterine arteries had been ligated, as soon as the uterus was removed, and after 45 minutes in fixative. The cervical diameter and length were measured two times as soon as the uterus was removed and after 45 minutes in fixative.

[History, organization and practice of American gynecology and obstetrics. An overview].

After a short review about the history of obstetrics and gynecology in the United States of America the course of postgraduate training, standards for examinations, certifying competence and control of the quality of education organized by the specialists themselves are reported on. The purposes of the American College of Obstetricians and Gynecologists, its structure and organization are outlined, also its tendency, to preserve the specialty as a whole one and to do not allow becoming fragmentated by many subspecialties. A high percentage of american women chooses the gynecologists to provide needed basal medical care.

Enterocele, vaginal prolapse, pelvic hernia: recognition and treatment.

Notable cul-de-sac relaxations or defects in 624 patients included 49 small pelvic hernias, 551 enteroceles (265 small, 200 medium-sized, and 86 large), and 24 cases of total vaginal prolapse. Methods of recognition are described, and one is illustrated. Four methods of operative treatment are described briefly, and two of these are illustrated.

Early identification, differentiation and treatment of ovarian neoplasia.

Among 3205 patients who needed major gynecologic operations, only 250 (7.8%) had significant ovarian cysts or tumors (170 benign, 38 "low malignant potential," 42 gross cancers). Contrary to prior reports, this study show that most patients with ovarian neoplasia had had some symptoms (duration ranged from two weeks to ten years), or a palpable adnexal mass or both.

The occasional need for myomectomy.

Only occasionally is there a good indication for either abdominal myomectomy or vaginal myomectomy. Among 3205 patients who had major gynecologic operations, 1022 had leiomyofibromas; 718 needed abdominal hysterectomy, 253 needed vaginal hysterectomy, and only 51 were treated by myomectomy. Vaginal myomas and a few submucous uterine myomas were excised vaginally.