Urology

This bimonthly series is aimed at educating physicians on the pertinent aspects of litigation. Each case study provides analysis of an actual ob/gyn lawsuit defended by the New York firm of Aaronson, Rappaport, Feinstein & Deutsch, LLP.

A 30-year-old woman presented to her physician with complaints of vaginal discharge that persisted for a year and required use of two to three pads per day. What was the cause?

Before choosing the appropriate surgical procedure, a two-pronged approach--transvaginal ultrasonography and CA-125 assessment--is the best way to determine the benign or malignant nature of an ovarian mass.

Patients need an individualized approach, says this expert in pelvic reconstructive surgery. Many factors determine whether minimally invasive versus invasive surgery, or abdominal versus vaginal routes of repair are best.

Should women be permitted to request a C/S? Physicians on both sides of the debate offer cogent arguments. What they say can help your own approach.

Two experts in the field of pelvic pain debate the merits of uterine suspension surgery and share their own clinical experience in managing this controversial condition.

For emergency C/S and vaginal hyserectomy, the benefits of prophylactic antibiotics are clear-cut. In contrast, studies evaluating prophylaxis for elective C/S and abdominal hysterectomy are harder to interpret. The authors review the evidence.

By helping Hispanic patients interact effectively with the health-care system, ob/gyns can increase the amount of prenatal care these women receive and decrease their high rates of preterm delivery and pregnancy-related maternal mortality.

Multiple births related to infertility treatment have increased dramatically in recent years and are associated with significant personal, economic, and social costs.

While colposcopy remains an essential diagnostic tool in the hands of an experienced clinician, the five technologies outlined here may eventually replace or at least supplement this important procedure.

The author looks at three cutting-edge products that use RF energy. Unlike the mono- and bipolar instruments in use today, these new devices cool tissue to create more powerful electrosurgical tools.

The ob/gyn's armamentarium for contraception continues to expand, with the addition of several new sustained-release devices that may increase patient satisfaction and compliance.

A rare but potentially catastrophic obstetrical complication, placenta accreta is on the increase, given the current trend toward elective repeat C/S. Three experts detail the best approach to management, which begins with antenatal ultrasound diagnosis.

News Briefs

When patients present with pelvic pain, the list of diseases to consider is long and includes ectopic pregnancy, acute salpingitis, a variety of sexually transmitted diseases, acute dysmenorrhea, cervicitis, endometriosis, fibroids, and uterine inversion. But in your search for gynecologic causes, dont overlook common neurologic disorders outlined in this article.

Therapeutic successes and a trend toward delaying childbearing now permit survivors of breast, ovarian, endometrial, and cervical cancers to consider future fertility. How should this affect the advice you offer your patients?

Once a rare complication of pregnancy, the incidence of placenta accreta has continued to increase since the 1930s. An expert on the disorder outlines the best approach to diagnosis and management.