Table Of ContentGYNAECOLOGY
20th EDITION
by Ten Teachers
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GYNAECOLOGY
20th EDITION
by Ten Teachers
Edited by
Helen Bickerstaff MD, MRCOG
Senior Lecturer in Medical Education
King’s College London
London, UK
and
Honorary Consultant Obstetrician and Gynaecologist
Guy’s and St Thomas’ NHS Foundation Trust
London, UK
Louise C Kenny MBChB (Hons), MRCOG, PhD
Professor of Obstetrics and Gynaecology
University College Cork
Cork, Ireland
and
Director
The Irish Centre for Fetal and Neonatal Translational Research (INFANT)
Cork, Ireland
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Dedication
This book is dedicated to the first and best teachers we ever had:
My Dad, Frank (HB)
My Mum, Elizabeth (LCK)
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Contents
Preface .....................................................................................................................................ix
Contributors ..............................................................................................................................xi
Abbreviations ...........................................................................................................................xiii
eResources .............................................................................................................................xvii
CHAPTER 1  The development and anatomy of the female sexual organs and pelvis ...........1
Helen Bickerstaff 
CHAPTER 2  Gynaecological history, examination and investigations .................................19
Helen Bickerstaff
CHAPTER 3  Hormonal control of the menstrual cycle and hormonal disorders .................33
Helen Bickerstaff
CHAPTER 4  Disorders of menstrual bleeding ...................................................................49
Helen Bickerstaff
CHAPTER 5  Implantation and early pregnancy .................................................................59
Andrew Horne
CHAPTER 6  Contraception and abortion ..........................................................................69
Sharon Cameron
CHAPTER 7  Subfertility ....................................................................................................91
Stuart Lavery
CHAPTER 8  The menopause and postreproductive health ..............................................105
Edward Morris
CHAPTER 9  Genitourinary problems ..............................................................................121
Margaret Kingston
CHAPTER 10  Urogynaecology and pelvic floor problems ..................................................135
Douglas Tincello
CHAPTER 11  Benign conditions of the ovary and pelvis ...................................................155
T Justin Clark
CHAPTER 12  Benign conditions of the uterus, cervix and endometrium ...........................169
T Justin Clark
CHAPTER 13  Benign conditions of the vulva and vagina, psychosexual disorders and 
female genital mutilation ............................................................................181
Leila CG Frodsham
CHAPTER 14  Malignant disease of the ovary ...................................................................193
Emma J Crosbie
CHAPTER 15  Malignant disease of the uterus ..................................................................205
Emma J Crosbie
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viii Contents
CHAPTER 16  Premalignant and malignant disease of the lower genital tract ....................213
Emma J Crosbie
CHAPTER 17  Gynaecological surgery and therapeutics ....................................................229
Douglas Tincello
Index ....................................................................................................................................249
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Preface
Gynaecology by Ten Teachers was first published in 1919 as ‘Diseases of Women’ and is one of the oldest, most 
respected and accessible texts on the subject. Gynaecology by Ten Teachers has informed generations of gyn-
aecologists, and now has a wide international audience. There is great responsibility in revising this landmark 
20th edition, to ensure its accessibility and relevance are maintained into the next century.
The 20th edition has been almost entirely rewritten to reflect both changing undergraduate medical cur-
ricula and changing diagnostic and management protocols in gynaecology. The ‘Ten Teachers’ are all inter-
nationally renowned experts in their fields and all actively involved in the delivery of undergraduate and 
postgraduate teaching in the UK. This volume has been edited carefully to ensure consistency of structure, 
style and level of detail, in common with those of its sister text Obstetrics by Ten Teachers. The books can 
therefore be used together or independently as required. New self assessment sections are presented consis-
tently throughout, with detailed clinical scenarios for each subject in a structure similar to those used in most 
medical schools.
The global status of women’s and girls’ sexual and reproductive health and rights is disturbing. Millions 
of women have no access to contraception, undergo female genital mutilation and receive no gynaecological 
care. It is fitting, therefore, that the 20th edition, published almost 100 years after the first, maintains a global 
aspect throughout.
The aim of the text now, as it was a century ago, is to prepare students for their undergraduate examina-
tions, and to continue to be useful afterwards in postgraduate studies and clinical practice. It is a text that 
the editors used as students, which inspired us to practice and teach in the specialty, and which we still enjoy 
reading because it is concise yet comprehensive. We hope that in addition to supporting medical students 
throughout their studies, general practitioners, trainees and allied health care professionals will find it useful 
in their work.
It has been a privilege and an honour to be the editors of this textbook as it approaches this important 
milestone; we echo a century of previous editors in hoping that this book will enthuse a new generation of 
doctors to become gynaecologists and work to improve the health and the safety of women through all repro-
ductive ages.
Helen Bickerstaff
Louise C Kenny
ix
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Description:First published in 1919 as 'Diseases of Women', Gynaecology by Ten Teachers is well established as a concise, yet comprehensive, guide. The twentieth edition has been thoroughly updated by a new team of 'teachers', integrating clinical material with the latest scientific developments that underpin p