A Focus on Women's Health
••Winter 2005/Vol. 9, No. 1

Book Reviews

A Woman's Guide to Surgical Options in the New Millennium: A Gentler Approach by Udo Wahn, MD | pdf >> Review by Linda Starr-Seaman Philadelphia (PA): Xlibris Corp, 2004. ISBN: 1413444369 (paperback:). 120 pages. $20.99

Dr Udo Wahn, a gynecologist with the Southern California Permanente Medical Group in San Diego, has written a small, remarkably informative book about--and for--women who may be facing problems, the solution to which might involve gynecologic surgery. This book follows on the heels of his and Dr B Bekkar's successful, earlier book, Your Guy's Guide to Gynecology,¹ reviewed in the Summer 2000 issue of The Permanente Journal.² Dr Wahn's objective with his new book is to provide and explain various options that are available for women who seek understanding and guidance about what they can do when the usual answers or choices have failed to solve the problem. With sensitivity and wit, Dr Wahn speaks directly to women about their innermost worries. His lighthearted manner and clarity of expression should certainly help reduce a woman's fears and enable her to achieve a more realistic perspective.

Chapter One, "a review of female anatomy," is necessary to help the reader to better understand the doctor's further assessments and recommendations for treatment. Chapter Two guides readers through the most common gynecologic problems, especially those that weigh heavily on women's minds because these problems may require surgery. Chapter Three discusses treatment options underlying surgical solutions. Here, Dr Wahn starts his discussion by explaining the most common treatment approaches but then proceeds to explain several newer techniques, including those that are considered to be at the forefront of medicine. Each technique is well described using language that will be understood readily by any woman seeking more understanding about her options.

For instance, reading the discussion of different avenues by which to approach common problems, I was struck by Dr Wahn's perspective on menorrhagia, or heavy menstrual bleeding. His plan of action for this extremely annoying problem is tailored for each patient and gives consideration for future fertility. He explains that the initial approach often includes use of birth control pills to control bleeding. Although for some women, medications may decrease blood flow, Dr Wahn proceeds to explain carefully that in other women, dilatation and curettage may be required to provide relief. Dr Wahn continues by explaining that if these methods are not effective, a woman may now consider the possible alternative of endometrial ablation instead of the oft-dreaded hysterectomy. This approach has other desirable effects, ie, less menstrual cramping and fewer symptoms of premenstrual syndrome (PMS). Various ablation methods are discussed. Each technique is shown to have its own advantages as well as disadvantages for both patient and doctor. Use of a well-selected approach--understood by a now-knowledgeable patient--often makes for a happier woman and improves the quality of her life substantially.

Other discussions in the book consider urinary incontinence and fibroids, again describing newer solutions that are less disruptive than conventional hysterectomy. Among these new, less invasive techniques discussed are uterine artery embolization, myomectomy, hysteroscopic surgery, and laparoscopic hysterectomy.

Overall, Dr Wahn discusses some of the most delicate physical concerns shared by women; and this feature alone will help many women who secretly suffer, needlessly thinking that theirs is an isolated case. Dr Wahn displays a deeply understanding approach toward the complex issues presented by female anatomy and psyche and offers clear approaches to common gynecologic problems experienced by women during their lifetime. The author obviously cares about women, and this is shown by the caring and compassionate manner with which he presents his discussions. The intellectual level of the book will appeal to the intelligent woman of today. An important resource, this book will undoubtedly interest any woman who prefers to have some prior understanding before finally walking into her gynecologist's office--after having fretted, agonized, and procrastinated until forced to face the unavoidable reality that she must see her doctor.

References

1. Bekkar B, Wahn U. Your guy's guide to gynecology: a resource for men and women. East Sandwich (MA): North Star Publications [Ant Hill Press]; 2000.
2. Gallo PC. Your guy's guide to gynecology: a resource for men and women, by Bruce Bekkar, MD and Udo Wahn, MD [book review]. Perm J 2000 Summer;4(3):84.

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