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1、CHAPTER71GYNECOLOGICSURGERYHowardW.Jones,IIItoundergofusionanddevolvestothevulvarstructures.Thepelvicembryologyandanatomylabialstructuresareofectodermalorigin.Theurethra,vaginalreproductivephysiologyintroitus,andvulvarvestibulearederivedfromuroepithelialclinicalevaluationentoderm.Thelowerthirdofthev
2、aginadevelopsfromthealternativestosurgicalinterventioninvaginationoftheurogenitalsinus.technicalaspectsofsurgicaloptionsTheinternalgenitaliaarederivedfromthegenitalridge.surgeryduringpregnancyTheovariesdevelopfromtheincorporationofprimordialgermcellsintocoelomicepitheliumofthemesonephric(wolffian)du
3、ctandthetubes,uterus,cervix,anduppertwothirdsoftheGynecologicsurgeryinvolvestheoperativetreatmentofbenignvaginadevelopfromtheparamesonephric(mullerian)duct.Theandmalignantconditionsofthefemalegenitaltract.Becauseofembryologicovariesmigratecaudadtothetruepelvis.Primor-thehormonalresponsivenessofthese
4、tissuesandorgansduringdialovarianfolliclesdevelopbutremaindormantuntilstimula-themenstrualcycleandduringthepremenarchal,reproductive,tioninadolescencebygonadotropins.Thepairedmullerianandpostmenopausalperiodsoflife,thediagnosis,management,ductsmigratecaudadandmediallytoformthefallopiantubesandevensu
5、rgicalapproachmaydifferbecauseofthehormonalandfuseinthemidlinetoformtheuterus,cervix,anduppermilieuandthepatient’sdesireforfuturefertility.Allthesefactorsvagina.Thewolffianductsregress.Failureorpartialfailureofmaybeevenfurthercomplicatedinpregnantwomeninwhomtheseprocessescanresultindistortionsofanat
6、omyandpotentialthesurgicalandanestheticapproachmustconsiderthepregnantdiagnosticdilemmas(Table71-1).uterusandfetus.Thesurgeonwhounderstandsandisabletoconsiderthephysiology,endocrinology,andanatomyoftheAnatomyfemalepelvisismostpreparedtoselectthemostappropriateandsuccessfuloperativeprocedure.Inadditi
7、on,byknowingtheExternalGenitaliaalternativestosurgeryandrisksandadvantagesofseveralpos-Theexternalgenitaliaconsistofthemonsveneris,labiamajora,siblemanagementapproaches,atreatmentmostlikelytocorrectla
