Anatomy and physiology of the breast The breast is a modified sweat gland made up of glandular tissue, fibrous supporting tissue and fat. Its purpose is to produce milk, but it also has a significant role in female sexual and…
Documentation and audit Clear and contemporaneous documentation of patient details, clinical findings, disease characteristics and discussions regarding options for management (both with the patient and with the multidisciplinary team) is crucial for safe patient management and for demonstrating this in…
Patients with breast concerns that cannot be adequately managed in primary care should be referred to a specialist breast clinic. This has traditionally been run by surgeons but is now a multidisciplinary enterprise. These clinics can perform a combination of…
The breast is a defining characteristic of mammals. Its fundamental purpose is to produce milk, but the appearance and sensation provided by breasts give them a huge role in female personal and sexual identity. Surgical and other therapeutic interventions on…
Introduction Outcome measures are the tools used to determine the efficacy, safety, and side effects of a treatment. Researchers assess outcome measures before and after treatments to determine their relative efficacy. Clinicians can use outcome measures to track the success…
This chapter discusses the evaluation, prevention, and management of many complications commonly associated with pelvic reconstructive surgery. Of note, it does not include a discussion of the evaluation and management of lower urinary tract injuries, which can be found in…
Introduction Although anterior vaginal prolapse is most common, loss of apical support is usually present in women with prolapse that extends beyond the hymen. There is growing recognition that adequate support for the vaginal apex is an essential component of…
Introduction Anterior vaginal prolapse occurs commonly and may coexist with disorders of micturition. Mild anterior vaginal prolapse often occurs in parous women, but usually presents few problems. As the prolapse progresses, symptoms may develop and worsen, and treatment becomes indicated.…
Introduction Synthetic midurethral slings (MUSs) have become the most popular surgical procedures performed for the treatment of stress urinary incontinence (SUI) in the twenty-first century. Few operations in gynecology or urology have been as well studied or have gained such…
Pelvic anatomy Bones of the pelvis The bones of the pelvis are the rigid foundation to which all the pelvic structures are ultimately anchored. In the standing position, forces are dispersed to minimize pressures on the pelvic viscera and musculature…