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ENDOSCOPIC SURGERY IN GYNECOLOGY . . . CONT.

Full bladder

Ovarian ligament

Round ligament

Broad ligament Fallopian tube

Uterosacral ligament

Ovary

Ovarian a. & v. (Infundibulo- pelvic ligament)

Ureter

Sigmond colon

Internal iliac a. & v. Common iliac a. & v.

Aorta

IVC

Figure 12. Posterior View of Internal Genital Organs

Rerinted with permission from Essentials of Obstetrics and Gynecology. 2nd ed. N.F. Hacker and J.G. Moore (eds). W.B. Saunders Co., 1992.

VIOLENCE AGAINST WOMEN

on average, women suffer abuse 40x before disclosing physician often first person to get disclosure

Epidemiology 1/10 to 3/10 women living with a man suffers physical or sexual abuse in their relationship wife assault leading cause of homicide for Canadian women occurs in families and in relationships of all socioeconomic, educational and cultural backgrounds increased incidence in: pregnancy, disabled women, age group 18-24 80% of male batterers abused as children and/or had witnessed wife abuse in their families as children 67% of battered women witnessed their mothers being abused

Physicians’ Role recognizing the problem

  • high index of suspicion, especially when injuries do not fit with

the history physical indicators: serious bleeding injuries (especially in central regions of body), bruises, welts, burns (electrical, cigarette,acid), dislocated and broken bones, torn ligaments, perforated eardrums, dental injuries

  • constant visits to the physician with nonspecific complaints such as headache, insomnia, palpitations, hyperventilation, stomach pain, chest pain, pelvic pain

psychological indicators: anxiety attacks, severe crying spells, feelings of being unable to cope, depression, suicidal thoughts, drug and/or alcohol abuse

  • injuries are often minimized by the woman and/or her

partner

MCCQE 2000 Review Notes and Lecture Series

Notes

Gynecology 53

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