Table Of ContentDewhurst's Practical Paediatric
and Adolescent Gynaecology
Second edition
Dewhurst's Practical Paediatric
and Adolescent Gynaecology
Second edition
D. Keith Edmonds MB ChB, MRCOG, FRACOG
Consultant Obstetrician and Gynaecologist, Queen Charlotte's and Chelsea Hospital, London
Butterworths
London Boston Singapore Sydney Toronto Wellington
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First published by Marcel Dekker Inc., 1980
Second edition, 1989
© Butterworth & Co (Publishers) Ltd, 1989
British Library Cataloguing in Publication Data
Edmonds, D. Keith (Douglas Keith)
Dewhurst's practical paediatric and
adolescent gynaecology — 2nd ed.
1. Young persons. Reproductive system.
Disorders
I. Title II. Dewhurst, Sir, C. John
(Christopher John), 1920- Practical
pediatric and adolescent gynaecology
618.1
ISBN 0-407-01520-5
Library of Congress Cataloging in Publication Data
Dewhurst, John, Sir, 1920-
[Practical pediatric and adolescent gynecology]
Dewhurst's practical paediatric and adolescent
gynaecology. — 2nd ed./Keith Edmonds
p. cm.
Rev. ed. of: Practical pediatric and adolescent
gynecology/John Dewhurst. cl980.
Includes bibliographies and index.
ISBN 0-407-01520-5 :
1. Pediatric gynecology. I. Edmonds, Keith. II. Title.
III. Title: Practical paediatric and adolescent gynaecology.
[DNLM: 1. Genital Diseases, Female - in adolescence.
2. Genital Diseases, Female - in infancy & childhood.
WS 360 D519p]
RJ478.D48 1988
618.92'098^dcl9
Typeset by TecSet Ltd, Wallington, Surrey
Printed in Great Britain at the University Press,
Cambridge
Foreword
The subject of paediatric and adolescent gynae friend, colleague and - I am proud to say - pupil,
cology is not new, children and adolescents having Keith Edmonds. He has taken the subject from the
suffered from disorders of the genital tract since the point at which I left it on my retirement in 1985 and
human race began. But awareness of the importance has further developed and refined it by the applica
of this subject is new. Twenty-five years ago, when I tion of his admirable surgical skills and intuitive
published my first book on the subject, only one understanding of his young patients. If, as I believe,
other had ever been produced. Now with interest in the reward of a teacher is the success of his pupil I
these matters widespread there are several of have been amply rewarded. The author of this book
which - in the words of the great C. Northcote is an accomplished paediatric and adolescent gynae
Parkinson - 'this is the latest and best'! cologist whose text reveals so well his knowledge
Every book should reflect its author and his and understanding of his subject, and his ability to
experience, and in this respect it gives me the pass on these things to his readers.
greatest possible pleasure to hand on the rewriting His book merits the greatest success. I welcome it
and updating of Practical Pediatric and Adolescent wholeheartedly.
Gynecology, which I first published in 1981, to my SIR JOHN DEWHURST
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Preface
The evolution of a special interest subject in the standard reference textbook for management of
paediatric and adolescent gynaecology has taken these problems throughout the world. It is fitting,
nearly 50 years. The first gynaecology ward for therefore, that this new edition of a practical guide
children and teenagers was set up in Prague in 1940 to management should bear his name.
by Professor Peter, and for 20 years very little The rapid changes and advances in this subject
progress was made. It was not until professor Sir have led to the updating of this book and the
John Dewhurst published his first book in 1963, considerable expansion of the reference section at
Gynaecological Disorders of Infants and Children, the end of each chapter. The book remains,
that the specialty was really established. The interest however, one which is aimed at offering real
then spread to the USA, where Professor John practical help for the clinician in the management of
Huffman in Chicago and Professor Vincent Capraro these disorders of childhood and adolescence.
in New York followed the lead of Dewhurst, cul I must thank Jack Dewhurst for his encour
minating in the publishing of The Gynecology of agement and help which have led to this publication;
Childhood and Adolescence by all three in 1968, and to Lesley Brooke Barnett who typed the
a second edition in 1981. manuscript, and to Rosalind Brodie for preparing
Thus, Jack Dewhurst may be looked upon as the the illustrations.
doyen of this subject, and is internationally I hope this book is of value to others and reflects
renowned for his contributions. But beyond all this the teaching I have received from Jack Dewhurst in
is the overriding ability Jack Dewhurst possessed as such a way that they and their patients can equally
a teacher. In 1980 Practical Pediatric and Adolescent feel the benefit his contributions have made to
Gynecology was published, which rapidly became medicine.
D. KEITH EDMONDS
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Contents
Foreword V
Preface vii
1 Patterns of childhood and adolescent
gynaecology 1
2 Intersexuality 6
3 Malformations of the genital tract 27
4 Vulvovaginitis and other vulval
lesions 46
5 Normal puberty 56
6 Precocious puberty 63
7 Delayed puberty 71
8 Menstrual disorders in the adolescent 86
9 Breast lesions and abnormalities of stature 95
10 Hirsutism and virilism 102
11 Tumours of the genital tract 112
12 Sexual activity in the adolescent 130
Index 144
