GYNAECOLOGY ILLUSTRATED David McKay Hart sw recsiies xcoc Consultant Gynaccologist, North Glasgow University NHS Trust and Honorary Senior Research Fellow, Department of Obstetrics and Gynaecology, University of Glasgow, Glasgore, UK Jane Norman wo mxcoc Senior Lecture, Department of Obstetrics and Gynaecology, University of Glasgow, Giaseow, UK Tseated by Robin Callander erm rsias am: “Medical Iustrator, Formerly Director of Medica llustrations, University of Glasgow, Glasgow, UK lan Ramsden Head of Medieal Ilustration Unit, University of Glasgow, Glasgow, U FIFTH EDITION EDINBURGH LONDON NEWYORK PHILADELPHIA STLOUIS SYDNEY TORONTO 2000CHURCHILL LIVINGSTONE ‘An imprint of Harcourt Publishers Limited ‘© Hiarcoure Publishers Limited 2000 Bis « vegistered trademark of Harcourt Publishers Limited ‘The right of David McKay Hart and Jane Norman o be identified as authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988, All rights reserved. No pare ofthis publication may be reproduced, ‘stored in a retrieval system, or transmitted in any form or by any ‘means, electronic, mechanical, photocopying, recording oF ‘otherwise, without ether the prior permission ofthe publishers (Harcour Publishers Limited, Harcourt Place, 32 Jamestown Road, London NWI TBY), or licence permitting restricted copying inthe ‘United Kingdom isued by the Copyright Licensing Agency, 90, ‘Tottenham Court Read, London W1P OLP. Fins edition 1972 ‘Second edition 1978 ‘Thied edition 1985, Fourth edition 1993 ith edition 2000 ‘Standard edition ISBN 0 443 06198 X. International Student Eainion ISBN 0 443 06199 & British Library Cataloguing in Publication Da ‘catalogue record for this book i available fro the British Library Library of Congress Cataloging in Publication Data ‘A catalog record for this book is aailale rom the Library of| Congress Note ‘Medical knowledge is constantly changing. As new information ‘becomes availabe, changes in treatment, procedures, equipment and the use of drugs become necessary. "The authors and the publishers hove as far as ts possible, taken cae to ensure chat the information fiver inthis ext is accurate and up to date. However, readers are Strongly advised to confirm thatthe information, especialy with regard to drug usage, complies with the latest legislation and Standards of practice Printed in China | |PREFACE Developments in gynaecological practice, including advances in medical treatment and increasing use of day-care surgery, have made it necessary to rewrite and update this book. Evidence-based practice has challenged some long-held beliefs and there have been particular advances in the management of infertility and malignant disease, Anew, younger, academic author has become involved to ensure that the book meets the requirements of the medical student and the primary care doctor. We have attempted to stress what is important and relevant in contemporary gynaecology and the emphasis on visual presentation, where possible, has been maintained. David McKay Hart Jane Norman