Gyn-Telegram - Uni-Frauenklinik Tübingen

Gyn-Telegram - Uni-Frauenklinik Tübingen

Gyn-Telegram
Forschungsinstitut für
Frauengesundheit
Update from the Department of Women’s Health
and the Tuebingen University Hospital for Women
August 2014
Dear Colleagues,
we are delighted to be able to present you with a new milestone in the development of
the Tuebingen University Hospital for Women.
With the establishment of the Department of Women’s Health, we have achieved even
better integration of the existing departments of the Women’s Hospital with current
research projects, all under one roof.
UniversitätsPerinatalzentrum
Level I
„Babyfreundliches
Krankenhaus“e.V. (BFHI)
e.V. WHO/UNICEF-Initiative
Zentrum für gynäkologische
Krebserkrankungen
(DKG-DGGG-AGO)
In light of this, we are especially proud of the results of our most recent study (see above), which proves for the first time in worldwide the literature that the quality of life and
most notably sexuality after laparoscopic hysterectomy is better than after total hysterectomy!
In this issue, we also report on the re-establishment of our Department of Women’s
Health, list all the quality assured and certified specialist departments of the University
Women’s Hospital, and invite you to an Open Day on Friday 19.09.2014 to mark the occasion of the opening of our new Outpatient Surgery Centre and our refurbished delivery
suite.
Latest FOCUS list of doctors, with the Tuebingen University Women’s Hospital being listed 4
times for:
1. Oncology
2. Breast cancer and gynaecological tumours
3. High risk births
4. Prenatal diagnostics
Universitäts-Brustzentrum
(DKG-DGS)
Zentrum für operative
Gynäkologie und MIC
AOPZ
Zentrum für
ambulante Operationen
Südwestdeutsches
Beckenbodenzentrum
Zentrum für Endokrinologie
und Reproduktion
Zertifiziertes
Endometriosezentrum
Dysplasie-Zentrum
Dysplasie-Zentrum
www.uni-frauenklinik-tuebingen.de
Department of
Women’s Health
Women’s Health Research Institute
Women’s Health Research Institute
• Experimental gynaecology
• Experimental Obstetrics
• Translational Oncology
• Prevention and health
services research
• Regenerative Medicine/
Medical technology
Obstetrics and Gynaecology
University Hospital for Women
• Gynaecology
• Prenatal diagnostics
• Obstetrics
• Oncology
• Endocrinology and
Reproductive Medicine
• Senology
• Urogynaecology
Women’s Health is the focus of the scientific activities and exceeds day to day gynaecology which is influenced by the rapid changes in society, health systems and research. Therefore we founded a Department
of Women’s Health according to an international centre of excellence.
Here, the components form a uniform concept which focuses on the woman/patient and subsequently on
a personalized medicine, expressed by the integrative collaboration between the University Hospital for
Women in Tuebingen and the first German Institute for Women’s Health.
With very best wishes,
Yours sincerely,
2
Prof. Dr. S. Brucker
Medical Director,
Women’s Health Research Institute
Prof. Dr. D. Wallwiener
Medical Director,
Tuebingen University Hospital for Women
Department of Women’s Health
Centre for
gynaecological oncology
DKG*
Breast Centre
DGS/DKG*
UroGyn
Perinatal Centre
AGUB*
MDK Level I*
Minimal Invasive
Assisted
Surgery Centre
Conception Centre
AGE Level III*
RP*
Dysplasia Centre
DKG
Endometriosis Centre
Level I *
Pelvic Relapse Centre
CCC *
Dysplasie-Zentrum
All certified centres at theTuebingen University Hospital for Women,
together under one roof.
3
Endometriosis
Centre
Endometriosezentrum
Zertifiziertes
Endometriosezentrum
Minimal Invasive Surgery for all endometriosis operations. Laparoscopic clearance of
deep infiltrating endometriosis, including bowel resection. Site: Complete resection of
Universitäts
- Kinderwunschzentrum
endometriosis in the pelvis and rectum.
Team: PD R. Rothmund, PD B. Krämer
Zentrum für
Endokrinologie
und Reproduktion
•
Hormonelle Stimulationstherapie und
UniversityUniversitäts
Assisted Reproducezing
- Kinderwunschzentrum
Inseminationen
•
Zyklusoptimierung, Behandlung von PCOS,
Hyperprolaktinämie
und Hypothyreose
• Hormonelle
Stimulationstherapie und
•
Hormonal stimulation therapy and insemination
•
IVF-/ ICSI-Therapie
mitoptimisation,
Weiterentwicklung
zur
•• Zyklusoptimierung,
Cycle
treatment
of PCOS, von
hyperproBehandlung
PCOS,
lactinaemia
and
hypothyroidism
IMSI NEU: Embryoskop
Hyperprolaktinämie und Hypothyreose
•
ICSI-Therapie
mit to
Weiterentwicklung
zur
•• IVF-/
IVF/ICSI
with advancement
IMSI NEW:
Kryokonservierung
vonNEU:
Eizellen,
Fertiprotekt,
IMSI
Embryoskop
Fetoscope
social freezing • Kryokonservierung von Eizellen, Fertiprotekt,
Inseminationen
•
•
• Kinderwunschsprechstunde
• social freezing
Hormone Clinic
• Hormonsprechstunde
• Hormonsprechstunde
• Beratungen zum
Cryoconservation of egg cells, FertiPROTEKT,
social
freezing
social freezing
•
Assisted Conception Clinic
• Kinderwunschsprechstunde
• Beratungen
zum on
Fertilitätserhalt
•
Counselling
Fertility
Preservation
•
social
freezing
Fertilitätserhalt
•
Social freezing
Assisted Reproduction Centre for the latest diagnostic and therapeutic assisted
reproduction techniques, including all minimal-invasive fertility surgery procedures.
Team: Dr. M. Henes, Dr. S. Hübner
4
University Perinatal Centre Level I, Baby-friendly Hospital
University Prenatal
Diagnostics
DEGUM Level III
UniversitätsPerinatalzentrum
Level I
Fetal medicine
Training and
examination Centre
„Babyfreundliches
Krankenhaus“e.V.
(BFHI)
e.V. WHO/UNICEF
-Initiative
Jeweils bestätigt durch
Re-Audit
Family-orientated, individualised Obstetrics and High-Risk Perinatology with the largest
Neonatal Clinic „wall to wall”.
Team: Perinatal Centre: PD H. Abele
Prenatal Diagnostics: Prof. K. O. Kagan (DEGUM III), PD M. Hoopmann (DEGUM III)
Centre for Paediatric and
Adolescent Gynaecology
Centre for Rare Abnormalities
of the Female Genital Tract
Age-appropriate care of girls from babies to teenagers.
Expertise in all types of genital abnormalities.
Team: Dr. K. Rall, Dr. V. Henninger, Dr. D. Stefanescu, Dr. B. Böer
5
Gynaecological Oncology Centre in the Comprehensive
Cancer Centre Genital Cancer Centre
Zentrum für gynäkologische
Krebserkrankungen
(DKG-DGGG-AGO)
Centre for
Gynaecological Oncology
Diagnostic
Interventional
Imaging
Gynaecology
Pathology
Urology
Human Genetics
General Surgery
Psycho-oncology
Systemische
Therapie
Rehabilitation
Radiation
Oncology
1.
• Development of an
individual treatment plan
2.
• Individualised treatment
of the “whole” patient
3.
• Monitoring of the
treatment plan
4.
• Supporting
convalescence
Interdisziplinary treatment
All types of gynaecological cancers (primary and relapse surgery).
Team: Prof. S. Brucker, PD R. Rothmund, PD B. Krämer, PD A. Taran
Pelvic Relapse Centre
Surgical
treatment
Precise
radiotherapy
Specific
pathological
sample
processing
Against the therapeutic nihilism in relapsing gynaecological malignancies.
Direction: Prof. D. Wallwiener, Prof. A. Königsrainer (General Surgery), Prof. A. Stenzl
(Urology), Prof. D. Zips (Radio-Oncology)
6
Interdisciplinary Breast Centre
•Gynaecology
•Diagnostic and Interventional Radiology
•Pathology
•Radio-Oncology
•Nuclear medicine
•Medical Oncology
Highlights
• Certified and sustainable quality management
• Development of new diagnostic techniques
• Leading Centre in the FertiPROTEKT Consortium
• Largest regional breast cancer network
• New Psycho-Oncology care concept, joint
projects with self-help groups
Largest Breast Centre, including aesthetic and reconstructive surgical techniques.
Team: Prof. Dr. E.-M. Grischke,
PD M. Hahn (Breast Sonography DEGUM III),
OÄ Dr. C. Röhm, OÄ Dr. G. Helms
Beratungszentrum
fürhereditären
hereditären BrustBeratungszentrum
für
Brust-und
undEierstockkrebs,
Eierstockkrebs
Counsellingim
Centre
for hereditary
breast and
ovarian cancer in a
Konsortium
der
Deutschen
Krebshilfe
Konsortium der Deutschen Krebshilfe
consortium with Deutschen Krebshilfe (German Cancer Aid)
Intensified early detection and counselling for patients with a family history and counselling with the Institute for Human Genetics.
Team: OÄ Dr. K. Bosse, OÄ Dr. I. Gruber
7
Operating Theatre of the Future
Opening of our
Outpatient
Surgery Centre
19.09.2014
Surgery Centre, Tuebingen University Hospital
Zentrum für operative
Gynäkologie und MIC
AOPZ
Zentrum für
ambulante Operationen
8
The latest integratively-controlled operating theatres with all medical technology and
endoscopic innovations, including 3D-laparoscopy.
Continence and Pelvic Floor Centre
Genital fistula
surgery
Südwestdeutsches
Beckenbodenzentrum
Urogynäkologische Operationen 2005-2013
10000
Sacral
neuromodulation
9493
9000
8000
7000
6206
Neurostimula
tor
6000
5000
4000
3000
Elektrode
2000
1000
0
OPS gesamt
•
•
Patienten
Constant long-term treatment
With multiple pelvic functional
defects: OAB, stool incontinence,
constipation, pelvic pain,
residual urine
Nerve-protecting
minimal invasive surgery
Sexual therapy
Continence and Pelvic Floor Centre for the optimisation of quality of life and sexuality with
the reestablishment of pelvic floor, bladder and bowel function.
Vaginal mesh for relapses (insufficient native tissue).
Team: Prof. C. Reisenauer, PD M. Hübner, OÄ Dr. S. Hahn
Dysplasie-Center
Dysplasie-Zentrum
Dysplasie-Zentrum
Changes in the portio, vagina and vulva
Condylomata and
HPV-associated
changes
•
Competent advice
•
Latest treatment
methods and
concepts
Care of dysplastic
changes during pregnancy
Number of patients attending the dysplasia clinic
2008 – 2013
Treatment of lichen,
dyspareunia and vulvodynia
Dysplasia-Colposcopy Centre: HPV-associated changes, lichen and vulvodynia.
Latest laser and electrocoagulation diathermy techniques.
Team: OÄ Dr. M. Henes, OÄ Dr. K. Rall, Dr. F. Neis
9
Family-centred obstetrics and high-tech obstetrics
The refurbishment of two delivery rooms at the Tuebingen University Hospital for Women is complete. The
Tuebingen Concept of family-centred obstetrics under the motto of “safe birthing” has been conceptually
and structurally implemented:
The rooms radiate inviting comfort, whilst incorporating the highest medical standards
Using a modular concept, the delivery rooms are suitable for the care of a normal delivery, but can also
be used as a complete operating theatre with facilities for artificial respiration (see pictures A and B). The
intensive medical technology is only visible when needed. The new digital documentation work stations
with integrated CTG-monitoring can be seen on the pictured below. Digital data exchange makes the
interdisciplinary work in the Perinatal Centre considerably easier.
Die neuen Kreißsäle der Universitäts-Frauenklinik Tübingen
A: Family orientated
B: Intensive care
The clear concept helps to alleviate concerns and promotes a feeling of safety and inner strength.
All variations of a natural birth can be supported.
Viewing: Wednesdays as part of the Delivery Suite Tour, 18:00.
10
Streptococcus – an old acquaintance newly evaluated
New findings have made it necessary to update the previous recommendations on the antenatal prophylaxis
of neonatal infection with group B Streptococcus. It could be shown that a general test for GBS during
pregnancy compared to the risk-related management led to a significantly (>50%) reduction in the number
of cases of early sepsis, without significantly increasing the number of women who received antibiotic
prophylaxis. Consequently, closely based on the American and Canadian recommendations and deviating
from the English recommendations, the present revised AWMF guidelines prefer a GBS screening for all
pregnant women from 35+ to 37+0 weeks to a risk related management. This screening is, however, still
not integrated in the previous pregnancy guidelines and therefore not included in the list of services covered
by the statutory health insurance companies.
All pregnant women should be microbiologically tested for GBS between weeks 35 + 0 and 37 + 0 of
pregnancy. Using swabs taken from the vaginal introitus and the anorectum, a statement can be made
about the probable GBS colonisation status at the calculated due date. The combined swabs increase the
detection rate of GBS by up to 30% and save money. Bacterial culture is the safest method. The use of rapid
tests to detect anogenital colonisation with GBS is not advised.
PD OA
Dr. Abele
OA Dr.
Pauluschke
-Fröhlich
Picture: Streptococcus pyogenes, CDC Public Health Image Library #211
A positive or negative antenatal swab result enables a clear course of action. In the case of an unknown
GBS status, the newborn must be hospitalised and monitored for 48 hours. In the interests of both the
mother and child, we therefore advise well-timed testing before delivery.
Since screening for GBS is still not obligatory in the pregnancy guidelines and because it is not covered
financially by the statutory health insurance companies, advice from the local gynaecologist about the
importance of this voluntary test is both important and necessary. With your good cooperation, we should
– despite the necessary IGEL problems – achieve a high rate of antenatal GBS screenings in our patients.
11
Tuebingen University Hospital for Women
in the Department of Women’s Health
Universitäts-Frauenklinik Tübingen
Pforte: 07071 29-82681 oder 29-82211
Private and Consultant
Out-Patient Clinic
08.00-16.30 Uhr
Private Specialist Clinic
Private Surgery Appointments
 07071 29-82212 oder
 07071 29-86301
Surgery Appointments general/ Outpatient Surgery Appointments/ Specialist Clinic
Appointments (Gyn)
Call Centre
08.00-17.00 Uhr
• General Clinic
• Genital Cancer Centre
• Breast Clinic
• Colposcopy
• Urodynamics
• Endometriosis
• Bone marrow aspiration
 07071 29-82224
Case Management
08.00-17.00 Uhr
 07071 29-82226 or
 07071 29-82681 (Switchboard)
Perinatal Centre
00.00-24.00 Uhr
Delivery Suite
 07071 29-83111
08.00-16.00 Uhr
Prenatal Diagnostics
 07071 29-84807
High-Risk Antenatal Outpatient Clinic  07071 29-86250
Paediatric and
Adolescent Gynaecology
08.00-16.00 Uhr
 07071 29-82255
Assisted Reproduction Centre
08.00-16.00 Uhr
 07071 29-83117
Termine
Prof. Dr. D. Wallwiener Medical Director
Tuebingen University Hospital for Women
Secretariat
 07071 29- 82246
 07071 29-2202
Bed management
07.00-15.00 Uhr
Emergency
Admissions
 07071 29-86311 or
 07071 29-82681 (Switchboard)
Oncology
08.00-16.00 Uhr
Day Clinic
 07071 29-82209
Oncology Out-Patient Clinic
 07071 29-82236
Gynaecological Oncology
Tumour Board
UFK Tü Level 06,
Small Lecture Theatre
Frau Gleich
07071-29-84809
Frau Breumann
07071-29-85099
Prof. Dr. S. Brucker Medical Director
Women’s Health Research Institute
Secretariat
 07071 29-80791
 07071 29-4663
19.09.14Tag der offenen TürUniversitäts-FrauenklinikTübingen
22.10.14Mini Airport MeetingFlughafen Stuttgart
15.11.14EndokrinologietagUniversitäts-FrauenklinikTübingen
29.11.-30.11.14 Mammasonographiekurs
Universitäts-Frauenklinik Tübingen
03.12.14Niedergelassenentreffen Rosenau Tübingen
23.01.-24.01.15 Tübinger Airport Meeting
Mövenpick Hotel Stuttgart
23.05.15DysplasiekursUniversitäts-FrauenklinikTübingen