The gynecology (from ancient Greek γυνή Gyné , Gen. γυναικός gynaikós , "woman" and -logie , "teaching, science") or gynecology , the doctrine of creation, detection, treatment and prevention of the disease is primarily of female sexual and reproductive tract.
The term was introduced into German literature in the 18th century and German-language literature in the 19th century.
The corresponding specialty for male patients is andrology , sometimes urology . However, urologists also deal with female patients when it comes to diseases of the kidneys , urinary bladder and urethra , and gynecologists deal with male patients when it comes to diseases of the mammary gland tissue.
In a narrower sense, gynecology deals with the diseases of non-pregnant women in contrast to its sub-area, obstetrics (obstetrics). Gynecology (in its broader aspects as Women's Health hereinafter) is one of about 30 sub-areas of human medicine . In Germany, specialist training is always carried out together with obstetrics.
The tasks of gynecology also include the treatment of diseases of the female breast and the corresponding preventive examinations (preventive medicine; see also mammography ).
Examination methods in gynecology
The most important examination methods in gynecology are ultrasound (see sonography ) to map the internal organs (especially the uterus ), as well as palpation ( ovaries ) and visual assessment using a speculum to examine the vagina and cervix , taking tissue samples and cells from the surface of the mucous membrane ( smear ) can be removed for examination.
For examinations and treatments in the area of the abdomen, the patient is usually placed on a gynecological chair so that the genital organs are easily accessible. Incidentally, microscopy should be mentioned as an important tool: For example, to detect a fungal infection of the vagina (candidamycosis).
Treatment spectrum in gynecology
Gynecology is one of the operative specialties of medicine. Some classic interventions: hysterectomy (removal of the uterus), tubal ligation (tying the fallopian tubes for sterilization), laparoscopic ovarian cystectomy (removal of ovarian cysts by means of keyhole surgery through the abdominal wall). However, gynecology also encompasses a wide range of conservative treatment methods, such as hormone therapy, counseling and implementation of measures for contraception and the treatment of couples who have involuntary childlessness .
Specialist in Obstetrics and Gynecology
In order to work as a specialist in gynecology and obstetrics after completing a medical degree in Germany , a five-year further training course is required, of which at least three years have to be completed in ward duty. The following can be counted towards this training period:
- Half a year each in anatomy , surgery , human genetics , pathology or urology . According to the new training regulations from 2006, other subjects such as B. Internal medicine recognized. Two years can be served with a resident doctor. In order to register for the specialist examination, an "OP catalog" and proof of independently performed diagnostic procedures or of at least 250 independently managed births as well as independently performed caesarean sections and vaginal-operative deliveries are required. In addition, all imaging methods of gynecology and obstetrics (general sonography, Doppler sonography, sonographic exclusion of malformations of the unborn child, urodynamic measurements, colposcopy, mammography, cytology, etc.) must be mastered. Specialization is possible in special gynecological oncology , special perinatal medicine and gynecological endocrinology and reproductive medicine . The specialization includes a further three years of advanced training after the specialist, which can be started at the earliest one year before the specialist. A further training course of 80 hours in basic psychosomatic care is also required.
Additional qualifications in gynecology
The additional qualifications are not part of the specialist training or the specialist training according to the training regulations. However, they enable them to carry out certain examinations or activities as trainers.
- Prenatal medicine : examinations of the unborn child and the pregnant woman are carried out in prenatal medicine practices in Germany. For this a qualification in the ultrasound examination according to the guidelines of the German Society for Ultrasound in Medicine (DEGUM) of the levels II or III is necessary.
- Urogynecology : This part of the subject, which deals with urinary and fecal incontinence as well as changes in the position of the genital organs, overlaps with urology and is operated by both gynecologists and urologists. In the field of gynecology, qualifications can be obtained in Germany in accordance with the guidelines of the Working Group for Urogynecology and Plastic Pelvic Floor Reconstruction (AGUB) of the German Society for Gynecology and Obstetrics .
- Pediatric gynecology: Pediatric and adolescent gynecology deals with congenital and developmental gynecological disorders in children and adolescents. This overlaps with paediatrics .
- Senology : Senology is the study of the female breast . In Germany, diseases of the female breast are treated in gynecology and surgery , especially plastic surgery . Special breast centers have been established to improve interdisciplinary collaboration in diagnostics and therapy .
- Minimally invasive surgery : Special skills in laparoscopic surgery and hysteroscopy are certified according to the criteria of the Gynecological and Obstetric Endoscopy Working Group (AGE) of the German Society for Gynecology and Obstetrics according to MIC I to III. The spectrum has recently been supplemented by ductoscopy , a reflection of the milk ducts .
There are trends within the specialist field of gynecology that want to define these additional qualifications as their own focus in gynecology. However, opponents fear the risk of a possible fragmentation of the gynecology. This would also make further training in gynecology more difficult, since not all clinics can provide the entire spectrum.
In Germany, around 5000 gynecologists are organized in the German Society for Gynecology and Obstetrics with its 21 thematic working groups, 8 regional societies and 12 German-foreign societies for gynecology and obstetrics, and around 13,500 in the professional association of gynecologists with 17 regional and 72 district associations.
- As of December 31, 2017, 25,515 gynecologists were registered in the Federal Republic of Germany , of whom 18,427 were employed.
- The largest gynecological clinic in Germany (located at one location) is that of the Eberhard Karls University in Tübingen : It has 140 beds and around 2,600 births per year. In the Rostock University Women's Clinic (Klinikum Südstadt), 3,200 children are born every year.
- In 1998 the gynecologists achieved an average of € 100,700 pre-tax practice surplus; in the new federal states € 75,000.
- At the beginning of 2001 there were still 68 open planning areas.
- Soranos of Ephesus (around 98-138), author of a standard textbook on gynecology
- Franz Kiwisch von Rotterau (1814–1852), founder of modern gynecology and obstetrics
- Gerhard Bettendorf (1926–2009), endocrinologist
- August Mayer , a founder of psychosomatic gynecology
- Heinz Kirchhoff (1905–1997)
- Heinrich Maass (1927–2016), senologist
- Kurt Semm (1927–2003), inventor of endoscopy
- Walter Stoeckel (1871–1961)
- Lutwin Beck : On the history of gynecology and obstetrics. On the occasion of the 100th anniversary of the German Society for Gynecology and Obstetrics . Springer, Berlin / Heidelberg 1986.
- Johannes C. Huber : Endocrine Gynecology. Maudrich Verlag, Vienna / Munich / Bern 1998, online version
- Barbara Maier: Ethics in Gynecology and Obstetrics. Decisions based on clinical case studies. Springer, Berlin / Heidelberg 2000, ISBN 3-540-67304-0 .
- Ulrike Havemann, Mahtob Bazargan: Gynäkologie , in: Margret Liehn, Brigitte Lengersdorf, Lutz Steinmüller and Rüdiger Döhler : OP-Handbuch. Basics, instruments, surgical procedure. 6th, updated and expanded edition. Springer, Berlin / Heidelberg / New York 2016, ISBN 978-3-662-49280-2 , pp. 395–443.
- Ann Dally: Women under the knife. A history of surgery. New York 1991.
- Anna Blanca Césarine Maria Delva (Ed.): Vrouwengeneeskunde in Vlaanderen tijdens de late middeleeuwen, met uitgave van het Brugse 'Liber Trotula'. (Philosophical dissertation) Bruges 1983 (= Vlaamse historical studies. Volume 2).
- Paul Diepgen : On gynecology in the Byzantine culture of the Middle Ages (= treatises of the Academy of Sciences and Literature. Humanities and social science class. Born 1950, Volume 1). Verlag der Wissenschaft und der Literatur in Mainz (commissioned by Franz Steiner Verlag, Wiesbaden).
- Andreas D. Ebert, Namal: Wilhelm Gustav Liepmann (1878-1939) - Expulsion from the first chair for social gynecology at the Berlin University to the University of Istanbul , in: Matthias David, Andreas D. Ebert (ed.): History of the Berlin University - Women's clinics. Structures, people and events inside and outside the Charité , Walter de Gruyter, 2010, pp. 238–250.
- Christ [oph] Ferckel: The gynecology of Thomas von Brabant. Munich 1912 (= Old Master of Medicine and Natural History. Volume 5).
- Isidor Fischer : History of Gynecology. In: J. Halban , L. Seitz (eds.): Biology and pathology of women. Volume I. Berlin / Vienna 1923, pp. 1–202.
- Monica H. Green: Obstetrical and gynecological texts in Middle English. In: Studies in the Age of Chaucer , 14, 1992, pp. 53-88.
- Gundolf Keil, Jörg Siegfried Kotsch: The “Erlauer Frauenbüchlein”. Investigations into a gynecological recipe from late medieval Upper Hungary. Text and comment. In: Specialized prose research - Crossing borders. Volume 4/5, 2008/2009 (2010), pp. 47-112.
- G. Klein: Old and New Gynecology. Festival ceremony for Franz von Winckel . Lehmann, Munich 1936. - Contents: Pictorial representation of the female anatomy from the 9th century to Vesal, famous obstetricians of the 16th and 17th centuries, the difference in the length of time that Japanese and European women give birth.
- Britta-Juliane Kruse: Hidden healing arts. History of gynecology in the late Middle Ages. (Phil. Dissertation FU Berlin 1994: Verborgene Heilkünste. Gynecology and obstetrics in manuscripts and prints of the 15th and 16th centuries ), De Gruyter, Berlin and New York 1996 (= sources and research on literary and cultural history , 5; also: Sources and research on the linguistic and cultural history of the Germanic peoples. Volume 239), ISBN 978-3-11-014704-9 .
- Britta-Juliane Kruse: "The medicine is worth gold". Medieval women recipes. De Gruyter, Berlin / New York 1999, ISBN 978-3-110-14703-2 (as e-book: 2013, ISBN 978-3-110-88587-3 ).
- Dorothee Leidig (Hrsg.): Gynecology in vernacular medicine and herbal books of the 12th to 15th centuries. An empirical study. Philosophical dissertation, Würzburg 2004.
- Chris E. Paschold: The woman and her body in the medical and didactic literature of the French Middle Ages. Verbal historical research on texts from the 13th and 14th centuries. With a critical edition of the gynecological chapter from the 'Amphorismes Ypocras' by Martin de Saint-Gilles. (Philosophical dissertation Heidelberg 1986) Pattensen / Hanover, now with Königshausen & Neumann, Würzburg 1989 (= Würzburg medical-historical research. Volume 47).
- André Pecker: Gynecology and obstetrics from ancient times to the beginning of the 18th century. In: Illustrated History of Medicine. German arrangement by Richard Toellner a. a., special edition Salzburg 1986, II, pp. 1002-1053.
- Max Schad: Gynecology and obstetrics at Ettner . Dissertation Munich 1943.
- Roland Siegmund: The 'Speyrer Frauenbüchlein'. Medical dissertation, Würzburg 1990.
- Website of the German Society for Gynecology and Obstetrics e. V. (DGGG)
- Website of the professional association of gynecologists e. V.
- Global Library of Women's Medicine , Global Library Ltd (English)
- Bavarian State Medical Association for specialist training (PDF; 501 kB)
- Martin Schurig: Gynaecologia historico-medica, hoc est consideratio congressus muliebris […]. Dresden / Leipzig 1730.
- Carl Gustav Carus : Textbook of Gynecology […]. 2 volumes, Leipzig 1820.
- Peter Schneck: Gynecology (modern times). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 429-435; here: p. 429.