The preferred route for a hysterectomy is vaginal. This means the entire surgery is done through the vagina with no incisions in the abdomen of any kind. The joke among surgeons is that it is a bit like taking a car apart through the muffler. While doing surgery entirely through the vagina may sound highly complex, it’s really just like any surgery. A vaginal hysterectomy done correctly it is an …
I saw this little news item from Shape Magazine about “vagina facials.”
First of all, the post means vulva. The vagina is inside and the vulva is the outside (where your underwear touches your skin). The vestibule is in between.
This what Shape Magazine had to say about it:
Created by Lisa Palmer, the facial came about after she “looked downstairs” and realized her vulva …
Preventing infection after surgery is very important as not only are these infections often uncomfortable and make you feel very sick, but they also increase the risk of more serious complications. For example, if you are less mobile because of an infection after surgery you are at higher risk for a blood clot or if you need a prolonged hospitalization because of an infection in your surgical wound you are …
I chose to become an OB/GYN because I love delivering babies and bringing joy to expectant parents. It is by far the most rewarding part of my job. Seeing the sense of pride on a new dad’s face, the joyful tears in a happy mother’s eyes, or the inquisitive look of a young big brother or sister is priceless and makes my “job” feel more like a privilege. Bringing a new …
A recent case that I saw in consultation at the patient’s request highlights the pervasive problem of overdiagnosis and overtreatment of endometrial hyperplasia. This 46-year-old woman was diagnosed with simple hyperplasia without atypia within an excised endometrial polyp, for which both her gynecologist and pathologist recommended hysterectomy. The basis for this recommendation was a perceived increased risk of endometrial cancer, either currently lurking within her uterus or to be developed …
To put this post in perspective the pain of childbirth is said to be equivalent of amputating a finger.
The joint statement of the American Congress of OB/GYN and the American Society of Anesthesiologists sums pain control during labor and delivery quite nicely: “There is no other circumstance where it is considered acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under a physician’s care. In …
Wendy Davis, gubernatorial candidate for Texas, has a new memoir Forgetting to Be Afraid. In it she describes terminating two pregnancies. One termination appears to have been in the second trimester for fetal indications and the other she describes as an ectopic pregnancy. She writes, “The only medical option was to have surgery to terminate the pregnancy and remove the affected fallopian tube — which …
There are two new high-tech ways that aim to help you with Kegel exercises, both with Kickstarter campaigns. There is the Skea (Smart Kegel Exercise Aid), basically a video game that proposes controlling the avatar with a vaginal probe that uses the pelvic floor muscles and kGoal, a vaginal insert that is meant to connect wirelessly with your smart phone and measures your squeeze …
During my third year of residency I trained for and completed an Ironman triathlon. I’ve discovered, despite its growing popularity, many people have no idea what a triathlon is and often nod at me in hesitant approval when I talk about this particular passion of mine. An Ironman triathlon is a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile run, completed in succession, all in one day.
And it happens …
Whenever new physician salary data is released, reporters and policy experts often compare doctor salaries in the United States to those of other countries: most notably, France.
And on cue, Vox’s Sarah Kliff — normally an excellent health care writer, by the way — is uncharacteristically lazy in framing physician salaries through a biased lens.
After presenting the data, …
There is a saying that you enter medical school wanting to help people but exit it wanting to help yourself. It may be a cynical view, but a realistic one. The criteria for being a good medical student are far different from being a good doctor. Medical education may be breeding a legion of self-serving, grade-grubbing, SOAP-note spewing machines rather than …
A friend delivered twins early. One is in the NICU, one died. What can I say or do?
This question was sent to me via Twitter. The person who added my name to the tweet knew that I might have something to offer because 10 years ago I was that friend. I entered the hospital with ruptured membranes at 22 1/2 weeks, pregnant with triplets. My son Aidan died at birth …
I used to think medicine would get easier over time. It makes sense, right? You see patterns, you learn how treatments work, and you just get to know stuff. Experience should make it easier to diagnose and treat.
That’s not been the case for me. In fact, it’s closer to the opposite. In the exam room, as I look up to the patient from my stool, and before I stand at …
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Emily Oster has a book coming out entitled Take Back Your Pregnancy. In preparation for the book launch, as most authors do, she wrote a nice piece in the Wall Street Journal about decision-making, risks, and how some of what OB/GYNs recommend during pregnancy isn’t always evidence based.
In particular, she mentions listeria, a bacteria that is a food borne illness with potentially devastating outcomes during pregnancy. Osher quotes the risk …
Last week a woman told me that she had a miscarriage in her bathroom. She was terrified. She didn’t know what to do. So she flushed it down the toilet.
A miscarriage is the spontaneous expulsion of a fetus from the womb before it is able to survive on its own. One in five pregnancies ends in miscarriage. Many women don’t know they are miscarrying. Those who know usually suffer grief …
On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred in the UK in late 2011, but has just come to light.
How could this have happened?
Let me count the ways.
The surgery was performed by two trainee surgeons. Their …
Typically, teen girls do not need a pelvic exam until they are 21. Most parents are surprised to hear this, especially if they know their teen is sexually active.
About 1/2 of teen girls are sexually active during high school which puts them at risk for sexually transmitted infections (STI) and unwanted pregnancy. However, for routine prevention and care, girls rarely need an internal pelvic or speculum exam during high school. …
The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver more appropriate care for injured and ill patients in Africa, Asia and Mexico.
Using an ultrasound to determine how dehydrated a child …
A divorced friend of mine who recently started dating was shocked to find that the complete absence of female pubic hair seemed to be an expectation among her potential partners. I’m not surprised, when I was in the dating pool a couple of years back there were men who actually listed full clamscaping required among the personal attributes they were seeking in a girlfriend (and here I was looking for …
With all due respect to the many caring, compassionate, and skilled male OB/GYN physicians out there, we’d be amiss in ignoring the research showing a near majority of younger women preferring a female gynecologist. Some call this reverse discrimination in gynecology. I’d more simply call it patient preference. The bigger question is, “Where does this leave the male gynecologist?”, especially in a current marketing climate promoting the “female only” OB/GYN …
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