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Williams (Ch 4 | OO) Ole) 4 HOFFMAN SCHORGE HALVORSON HAMID CORTON SCHAFFER Mc Graw Hill Williams GYNECOLOGY NoTIce Mallioe an ecu ence Aa tow fsa snd lk epee been our now ge chy ueumen cn ig hompy ae reed. The autho ad he pbs of ‘ron ve hei with abled be sole a ar foto reve forma hat Compl and penile scord wh he anda arp ot he neo pubin, Hower, Ine of ie pomiiy of nan enor or cing stellen oh the ator noe the phe oo ary ober pry who bs been ole inthe pepartin ox pbleaton a his ‘rok warn dhrhe infrmon conte hen wn eey reper cab comple, sh they ici al posi f any exons: the sera! from wef the Inrmatonconcie n i wae Redes are encouoge cat te inhrmaton cone ein wih ther oe er eampl in pric, eer ae mv check the pot Informacion set caddie pogo ach dg they pnt ain n Deca he Inman cone hie cae and tht changes en en ne nthe eco ‘emia dow o nthe contains snr Th common of pare Inport conacion wis aw or neqpey aed dug Williams GYNECOLOGY FOURTH EDITION Barbara L. Hoffman, MD John 0. Schorge, MD sa M.Halvorson, MD Cherine A. Hamid, MD Marlene M. Corton, MD Joseph |. Schaffer, MD Mc IGraw Hil NNewYotk Chicago Sin Frcino Ubon Londen Made Masco Cy Milin New Debi ‘Sin juan” Seo ‘Singor Syéney Toren (Copyright & 2020, 2016, 2012, 2008 by Mctiraw-Hill Education. All nghts reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reprocuced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-1-26-045687-5 MHID: — 1-26-045687-0 ‘The material inthis eBook also appears in the print version of this ttle: ISBN: 978-1-26.045686.8, MHID: 1-26-045686.2. ‘eBook conversion by codeMantra Version 1.0 All trademarks are crademarks of their respestive owners. Rather than put a trademark symbol after every occur- rence ofa trademarked name, we use names in an editorial fashion only, and tothe benefit ofthe trademark owner, ‘with no intention of infringement of che trademark, Wheze such designations appear inthis book, they have been printed with initial caps. ‘MoGraw-Hill Education eHooks are available at special quantity discounts to use as premiums and sales promo- tions or for use in corporate training programs. To contact a representative, please visit the Contact Us page at ‘www mhprafessional.com, TERMS OF USE ‘This is a copyrighted work and McCraw-Hill Kduca‘ion and its {censors reserve all rights in and to the work. Use of this werk is subject to these terms. Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, vou may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, dsirbure, disseminate, sell, publish or sublicense the work or axy ppatt of it without McGraw-Hill Bducatiou’s prios consent. You may use the work for your own noncommercial and personal use; any other use ofthe work is strictly prohibited. Your right to use the work may be terminated if ‘you fail to comply with these terms. THE WORK. IS PROVIDED “AS IS" MeGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO. GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF (OR RESULTS 10 BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill [Education and its licensors do not warrant or guarantee thatthe functions contained ia the work will meet your requirements or that its operation will be uniaterrupted or error free, Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone cise for any inaccuracy, exror or omission, regardless of cause, in the ‘work or for any damages resulting thereftom. McGraw-Hill Education bas no responsibilty for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licen- sors be lisble for any indirect, incidental, special, punitive, consequential or similar damages that result from: the use of or inability to use the work, even if any of them has been advised of tae possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tortor otherwise, IN MEMORIAM Kristin Paulson Landon Easy in production of his editor, our Willams family lst a dedicated member ofthe tam in Ms, Kristin Landon, ‘We law hee as ou valued copyedior fr many eons of both Wiliam Outer and Wiliams Geology However, Kein fe wae muldfacersd, with elene tha included analy chemist, musician, cooking enchusiat, and iter, Indcod, hex published science fon novels incl the Hidden World wlogy and Windlome. We knew ‘Klin aan iaegial member of our textbook tum. Her preson added dari to our ets and made our rextbooks bers. This page intentionally left blank DEDICATION “Thisadon of Willams Gynecology edited to Dr. Kaen Badan who has seve a Eto of Willams ‘Gmeclogy inc is nail edn, We are especialy ref fore tenacity during the Formative oars of or [poet ne he sedi suppor bring our Beton to prin. Our texte conen har beefed prey rom herein acumen coupled wih a maseryof he evidence bated irre. Her lear conc chap died cfallenging productive endocrinology tenet ino ely undermood conexps that ater the bed Indo, thr many teaching sare throughou her care set ts ge 1s. Bradshaw rot athe Unversty of Texas Southweterh rin deep and include her medial school years dency ining nd felomip sy in Reprodcve Endocrinology and nfl Esly inher caret a3 ety member t UTSW, she base Dizecror of the Asited Reproduce Technologies Progam. Subequenhy she Indped develo the Pedic Gneclogy Servic at Chien Hospital which was S for Dall nd conn to thi day. This was the fi of many eallaboraive and muldplinary projects tha py her carer As another ‘ample she was instrumental in expanding the eld of minimally invasive srgery (MIS) ao nition and Inte she apamscopy Teaching Service. Sh przered withthe Deparment of Sorgey and was provided joint zpoinement 0 fer MIS developmen, Sh sre onthe Southern Minimally Invasive SungryEacaive ‘Commins fom inception in 1997 wn her rerement in 2019. Tadic ro scademics, De. Bradaaw wer incall and adminiinely ative in ou expanding pate price con campus. Asan avocat of heh for women a they entered and advance thraugh menopatc she war the at alder ofthe Hen J and Rober S. Sass and Dara Land Richard C. Sass Distinguished Profewoahip ia ‘Womens Hea. Her vison lal development ofa ng, mull et cae forthe various heath specs cof mature women. This was subsequently endowed and became the Lowe Foundation Cem for Womens Preenatie Heath Care Daring her academic caer, Dr. Bradshaw promoted academic excelence a TSW. She served adminis con numero academic committer volved with matic ool, raidency, and specy ening. Moreover, Kren ‘war paoateadoct forthe advanzment of women in academia tor inition. She war a 3 voi om the ‘ato seademic nage. Kare served onthe Board ofthe American SoceyofReprducive Endocinology and Inferligy nd eens paricied in her png ning ore. She led prominent adeip mex in the Soci for Reproductive Endocrinology and Ini, inlading president In both ogniions she cily rand bth redeny snd fellowship tiningin the pei. Toru inthe Deparment of Oeics and Gysecsogy, Dr, Bradshaw hat played an important rl at mentor and calleague. Her oxpience and cnc espetse hae been valle, and she har provided gulnc for chalenging _peclogy ces On vo many lees, we fave benefited grey fm her academic and cinemas This page intentionally left blank CONTENTS Editors. Contributors. Artists Preface . ‘Acknowledgments (GENERAL GYNECOLOGY S.WeEWOMAN GE cesses: 8 Adnan bb BedngsesD 2 Tenis rig eg ne og i208 In Gynecology. a aD 49; Benign Adnexal Mass .. 219 GaN an errno eee ee fe 4 Benn Dre ofthe Lower Reproductive Tract.. 92 Tc Pelie Pat said 5. Contraception and Sterilization .........111 Tac rest Dee a 6 Fates Abononecccctsy Ye Parhseclisuesand ‘xeRople Reon: vvr161 45, Pediatricand Adolescent Gynecology ...320

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