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Adenomyosis is a benign disease of the uterus in which components normally limited to the endometrium (the thin innermost uterine layer) are found within the myometrium (the middle muscular layer of the uterus). The exact prevalence of adenomyosis is not known because the diagnosis can be made only by microscopic examination of uterine specimens obtained during surgery or, less often, during biopsy.

A study published in the Journal of the American Medical Association asserts that 43% of American women are experiencing some sort of sexual dysfunction during a 12 months period. As a result, female sexuality has become the new mass media debate. With all that exposure many women are wondering if something is wrong with them? What’s going on?

I've been seeing a man regularly for the past year. We get along great and the chemistry is there – lots of love on both sides. However, I feel growing anger. I've been waiting for him to ask me to live with him or get married. I've been giving him plenty of hints but it's not working. I think he likes it the way it is. I don't want to lose him but the stress of waiting really affects my feelings. Why can’t I get him to act? How long should I wait?

I was a dysfunctional husband throughout my marriage because of my marijuana habit. After we separated, my father took ill and my Mom’s health was failing so I was back and forth to help her.

If you have just been told that you may need to have a hysterectomy, what are you feeling? Frightened, uncertain, vulnerable, angry, out of control -- don't panic. I don't think anyone could have had any more of a negative reaction than I did when I was told, "you should probably think about having surgery."

Post Op Tips

Talk w/your anethesiologist before surgery to let him know any concerns, fears and what to expect when you wake up. If pain or feeling sick are issues, he/she can help make this easier! It is possible to wake up feeling pretty good and able to eat afterwards!

More than 10 million American women suffer from excessive menstrual bleeding or heavy periods, a condition known as menorrhagia. In fact, more than 20 percent of the 600,000 hysterectomies performed annually in the United States treat menorrhagia. But because this health issue is so rarely discussed, few women realize that the condition can be easily treated during a 30-minute outpatient procedure as opposed to having a hysterectomy.

Designer estrogens, SERMS, are two terms currently being used to describe the actions of a medication that acts as an estrogen on one tissue and an anti-estrogen on others. The ideal estrogen medication would switch of or off the effects of estrogen at different sites in the woman's body.

It's 2:00 a.m. on a Friday. Your doctor is home in bed, where the rest of the world should be. But not you...you're online wondering whether this stomachache you have is life threatening or just a bad reaction to the steak you had at dinner. So where do you go? Do you rush to the hospital to wait 3 hrs. in the ER to be told to "go home and call your doctor," for the "small fee" of $1000 or so?

Entering the word ‘contraception’ into a search engine will result in over one million hits, from commercial sites to personal homepages and scientific sites. How can the physician find the information s/he is seeking in this overwhelming labyrinth? This review presents a guideline for quick access to practical professional information in the field of contraception and reproductive health care.

The source of chronic pelvic pain may be reproductive organ, urological, musculoskeletal - neurological, gastrointestinal, or myofascial. A psychological component almost always is a factor whether as an antecedent event or presenting as depression as result of the pain.

Endometriosis is a condition in which the lining of the uterine cavity (endometrium) grows outside of the uterus. Endometriosis can be found anywhere in the pelvic cavity, including all the reproductive organs as well as on the bladder, small bowel, colon, rectum, appendix, and vagina. However, endometriosis cannot be considered simply as misplaced endometrium, because it differs in hormonal responses and visual appearance.

The real cause of endometriosis remains unknown. The following theories represent current thinking of the etiology of endometriosis, but none of them can explains all cases of endometriosis. We do know, however, that endometriosis is not caused by anything that the patient has done.

Patients with endometriosis can have symptoms varying from constant excruciating pelvic pain to no symptoms whatsoever. Paradoxically, the extent of endometriosis has no correlation to the amount of pain a women will experience. Some women with severe endometriosis do not have any symptoms and may not know they have endometriosis until a pelvic mass is detected on a routine pelvic examination or a problem with infertility is discovered.

Advances in technologies have allowed conduct of many procedures by laparoscopy and hysteroscopy. These are the essence of our specialty. Most new technologies foster improved performance. In business term, they are called sustaining technologies. In fact, most technological advances in an industry are sustaining in nature.

ISGE July 2005 Volume 13

We are in the cyber-era. Many conventional “snail” mails have been replaced with emails. Electronic mails allow easy, fast and economical communication. It is ideal for short messages, and quick questions and replies. For ISGE with members from around the world, it is a convenient way to communicate; time-zone is not a factor anymore. You send your e-mail and the receiver replies at his or her convenience. It helps us stay connected.

Suppose for instance, that last year, the chair of an organizing committee invites you to lecture at a meeting. You accept. You then assist this chair in organizing the program by inviting other speakers to the meeting. Two months before the meeting, the invitation for you to speak is withdrawn.

In minimally invasive surgery (MIS), complications can occur due to faulty instruments, surgical technique, or inadequate patient election. Surgeons who routinely perform MIS rarely encounter complications. Conversely, practicing gynecologists at large often find that certain procedures or techniques are not as safe as previously reported in the literature by the "experts." One of the reasons is that complications tend to be underreported.

The tragic events of September 11 have, to put it mildly, thrown many people off balance. On a somewhat secondary scale, our Society was affected. The 5th Regional Meeting of ISGE in conjunction with the 2nd Brazilian Congress of Gynecologic Endoscopy took place on September 12-15, 2001.

We are entering a time in the development of the discipline of gynecologic endoscopy where there is an opportunity to build bridges, both ideologically and functionally. The science and practice of endoscopy have progressed to the point where core groups of advanced endoscopic surgeons have organized themselves in every corner of the world, not only to exchange knowledge, but also to set goals and plan for the future of the field.

Uterine prolapse or dropped womb is a condition in which the uterus drops downward in the pelvis below its normal position. The uterus may drop slightly and remain above the introitus (vaginal opening, grade 1). It may drop further so that the cervix or lower portion of the uterus reach the region of the introitus (grade 2). In the most severe form, the cervix or even the entire uterus bulges out of the introitus (grade 3). Uterine prolapse is the indication for hysterectomy in 16% of cases in the U.S.

Despite the major public health impact of leiomyomas, little is known about their cause. Until recently, the steroid hormones estrogen and progesterone were considered the most important regulators of leiomyoma growth. There is abundant evidence that estrogen promotes fibroid growth including the clinical observations that fibroids grow in the presence of high levels of estrogen, such as during the reproductive years, and that they regress in the presence of low levels of estrogen, such as following menopause or during gonadotropin releasing hormone (GnRH) agonist therapy.

The first laparoscopic hysterectomy was performed in 1989 by Henry Reich. Nowadays the laparoscopic hysterectomy for a uterus up to 300 grams, without other pathologies that could limit its mobility or without a poor vaginal access, has to be considered a basic well standardized procedure.