Obstetrics and Gynecology Clinics of North America

Minimally invasive surgery is now standard of care for many procedures in pediatric gynecology. Laparoscopy has been well documented to produce faster recovery,decreased postoperative pain, and because of smaller incisions, a better cosmeti…

In this review, the pitfalls that still exist with the surgical treatment of endometriosisassociatedpelvic pain have been discussed and the best evidence regarding various aspects of surgical techniques have been reviewed. When laparoscopy …

Ultrasound should be considered the first-line imaging modality of choice in women presenting with acute or chronic pelvic pain of suspected gynecologic or obstetric origin because many, if not most, gynecologic/obstetric causes of pelvic p…

Complications may occur during laparoscopic surgery, even with a skilled surgeon and under ideal circumstances; human error is inevitable. Videotaped procedures from malpractice cases are evaluated to ascertain potential contributing cognit…

The presence of endometrial glands and stroma outside the uterus, typically in the pelvis, is known as endometriosis. An adolescent with this diagnosis usually presents with chronic pelvic pain, and she and her family are anxious for an exp…

This article lends the urologist's perspective on complaints commonly seen in a pediatric and adolescent gynecology practice, such as perineal pain, repetitive posturing, vulvovaginitis and interlabial masses. Evaluation and management of u…

Dyspareunia, better termed women's sexual pain, is a poorly understood disorder once believed to be purely psychologic. Thanks to cooperative research efforts from several specialties toward defining subsets of the disorder, understanding t…

Fibroids are a prevalent disorder occurring in at least half of American reproductive-age women. In general, the incidence and size increases with age. Most women never attribute or report any symptoms from their fibroids, and because of th…

Information is still being collected on the long-term clinical responses and appropriate patient selection for UAE. Prospective RCTs have not been performed to compare the clinical results from UAE with more conventional therapies for sympt…

Deep endometriosis is essentially characterized by the presence of a rectovaginal or retrocervical nodule, which is a circumscribed, nodular aggregate of smooth muscle, endometrial glands, and, usually, endometrial stroma. The authors sugge…

The use of laparoscopy by gynecologists in treating pediatric and adolescent patients is a relatively new phenomenon. This article discusses the specialized instrumentation necessary for operating on these patients and preoperative consider…

Reproductive performance is now more than ever determining the choice of treatment for each individual couple. The easy access to ART treatments, their financial benefits, and the relative high success rate per cycle are at the basis of a l…

Laparoscopy is a useful tool for the diagnosis and treatment of conditions associated with chronic pelvic pain. In the evaluation of chronic pelvic pain, laparoscopic techniques vary from conservative procedures, such as pain mapping, excis…

Abnormal and irregular bleeding are extremely common in the adolescent period and can be looked upon as a part of normal reproductive development. It is essential to have a firm grasp on the normal, physiologic development of the menstrual …

Adenomyosis is characterized as ectopic endometrial tissues within the myometrium in the uterus. The etiology and pathogenetic mechanism(s) responsible for adenomyosis are poorly understood. Definite diagnosis is made on hysterectomy specim…

Endometriosis is a cause of chronic, pelvic pain in adolescents. Lack of response to NSAIDS and OCPs should prompt further investigation and subsequent treatment. The goal of therapy is to minimize pelvic pain and dysmenorrhea primarily thr…

The quality of the evidence that supports the use of medical treatment before conservative surgery for endometriosis is manifestly poor, and no recommendations can be made based on the results of the published studies. There are practical a…

Future research in endometriosis must focus on pathogenesis studies in the baboon model, the early interactions between endometrial and peritoneal cells in the pelvic cavity at the time of menstruation, and potential differences between eut…

Endometriosis long has been recognized as showing heritable tendencies, with recurrence risks of 5% to 7% for first-degree relatives. The risk indicates that polygenic and multifactorial etiology is far more likely to be the cause than mend…

Prospective and retrospective clinical trials suggest a decreased oocyte and embryo quality in women with endometriosis. Based on these observations, the authors described an altered intrafollicular milieu in endometriosis, which explains t…

Management of infertility associated with endometriosis remains challenging. The clinician must rule out all other causes of infertility before creating a treatment plan. It is important to remember that women with infertility and endometri…

In the coming years, basic science research into the mechanisms of endometriosis development and persistence almost certainly will open new avenues for treatment. A wide armamentarium of medical therapies already exists, however. The effica…

Endometriosis is defined by the presence of endometrial tissue outside the uterus. Clinical and basic research in endometriosis has been hampered severely by the lack of accurate noninvasive diagnostic techniques. Transvaginal ultrasonograp…

Endometriosis is a common gynecologic disorder characterized by the presence of endometrial tissue outside the uterine cavity. Various theories have been put forth to explain the mechanisms for the development of this disease. Although no s…

Finding the solution for the pain of endometriosis is likely to be a time-consuming, often frustrating task. But it is a task that can begin in earnest only once the pain is identified and believed. If a girl or woman with endometriosis is …