克氏外科学19版chapter 71.pdfVIP

CHAPTER 71 GYNECOLOGIC SURGERY Howard W. Jones, III to undergo fusion and devolves to the vulvar structures. The pelvic embryology and anatomy labial structures are of ectodermal origin. The urethra, vaginal reproductive physiology introitus, and vulvar vestibule are derived from uroepithelial clinical evaluation entoderm. The lower third of the vagina develops from the alternatives to surgical intervention invagination of the urogenital sinus. technical aspects of surgical options The internal genitalia are derived from the genital ridge. surgery during pregnancy The ovaries develop from the incorporation of primordial germ cells into coelomic epithelium of the mesonephric (wolffian) duct and the tubes, uterus, cervix, and upper two thirds of the Gynecologic surgery involves the operative treatment of benign vagina develop from the paramesonephric (mullerian) duct. The and malignant conditions of the female genital tract. Because of embryologic ovaries migrate caudad to the true pelvis. Primor- the hormonal responsiveness of these tissues and organs during dial ovarian follicles develop but remain dormant until stimula- the menstrual cycle and during the premenarchal, reproductive, tion in adolescence by gonadotropins. The paired mullerian and postmenopausal periods of life, the diagnosis, management, ducts migrate c