The da Vinci Surgical System is the only commercially approved system for
gynecologic surgery.

The system allows the surgeon to control the instruments with finger graspers
and foot pedals. A robotic cart holds the instruments. A visual system creates a
3D image. The hands of the surgeon direct the movement of the surgical
instruments.

The main surgeon is not scrubbed for surgery and sits at the controls. The
tam of assistants help place the instruments and pass the sutures through small
incisions. 

Circumcision
is the removal of the foreskin from the penis. Circumcision was mostly
performed on those of the Jewish faith. An article in a medical journal
in the early 1900's promoted the "cleanliness" of circumcision.

The percent of circumcised males rose from 30% in the 1930's to 90% in the 1970's. Currently, the rate is about 60% in the USA.

Some
theoretical benefits of circumcision include reduction in urinary tract
infections (very rare), some protection against sexually transmitted
diseases, and a lower rate of penile cancer.

Submitted by Dr. Joe Edwards on Sun, 2010-02-07 23:57

The perimenopause
is the name given the constellation of symptoms that women experience
prior to the onset of menopause. The transition time may vary from a
few months to several years.

he first subject concerns hormone replacement therapy, which became
controversial after the large Women's Health Initiative (WHI). The
average age of menopause is 51 years of age.

The classic symptoms
involve hot flashes, vaginal dryness, mood swings, nightsweats, urinary
issues, cognitive functions, sexual dysfunction, and reduced quality of
life. 

The persistence of the symptoms vary greatly among
individuals. Treatment options include estrogens, progestins,
androgens, antidepressants, alternative medicine, and selective
estrogen receptor modulators (SERMS).

Migraine headaches have four phases: 1) the prodrome (beginning); 2)
the aura or visual disturbances that precede the headache; 3) the
headache; and 4) resolution.

The prodrome may vary in
presentation but usually presents as weakness, poor concentration, or a
stiff neck. This phase can last for hours or days.

The aura may present as visual changes and lasts approximately sixty minutes or less.

I have enjoyed writing the blogs but it is sometimes difficult to come up with new topics that have not already been covered. I hope in the new year that you will find the time to make the blog more interactive. If you have privacy concerns, please email me at joeedwardsmd@gmail.com.

The following is a list of topics that I have written about since the blog began.

Cesarean section

Pap smears

Osteoporosis

Menstrual cycle

Polycystic ovarian syndrome

Vaginal birth is preferable to cesarean section in most cases. There are several reasons that a cesarean section needs to be performed. The failure of the cervix to dilate, the failure of the fetal head to descend into the pelvis, fetal position, fetal size, and the infant not tolerating the contractions (heart rate dropping) are just a few of the reasons.

The American College of OBGYNS (ACOG) recently changed the recommendations for pap smear screening. The first cancer screening can begin at age 21 regardless of first sexual intercourse. The reasoning is based on the rare occurrence of invasive cervical cancer under the age of 21.

The United States Preventive Service Task Force (USPSTF) recently announced new recommendations on screening for breast cancer. The full report will not be available until later this year.

The summary statement acknowledges that mammogram screening reduces the mortality from breast cancer. As one ages, the chance of developing breast cancer increases. By the age of 82, one in eight women will have developed breast cancer.

The definition of osteoporosis is a bone mineral density (BMD) 2.5 standard deviations below peak bone mass. Bone is in a constant state of fluctuation between resorption and formation. Osteoclasts break down the bone and osteoblasts rebuild the bone.

The imbalance between these processes leads to the thinning of the bone. One of the main problems is that osteoporosis has no symptoms. Fracture of the vertebral bodies (backbone) and the long bones (hips) make osteoporosis a concern.