Over the past 20 years surgery has become increasingly sub-specialised and further still, in the past decade, there has even been specialisation within the new sub-specialties. Although overall this has been beneficial, it has also led to the creation of artificial anatomical boundaries between specialties. This is perhaps most obvious in the pelvis which for surgical purposes has been divided into three distinct areas; the urologists working in the front, the gynaecologists in the middle and the colorectal surgeons at the back. Many of the disease processes found in the pelvis however, fail to conform to these distinct boundaries and require a multi-disciplinary approach. Indeed in several countries the concept of the "pelvic surgeon" is emerging who is able to undertake operations that would formerly have been considered to be strictly in the disciplines of proctology, gynaecology or urology. Irrespective of this development it is now recognised that all surgeons who operate in the pelvis require the skills to deal with pathology that extends to adjacent organs. In this respect they must as a minimum have an understanding of the skills that other specialists may contribute to the management of the patient. Although this is increasingly recognised in multi-disciplinary meetings and conferences, no such textbook current exists that is designed to appeal to the Pelvic Surgeon or to the specialty surgeon operating in the pelvis.
The anatomy of the pelvic floor and pelvic organs.- Urogenital Prolapse.- Rectal prolapse.- Gynaecological and rectal prolapse.- The rectal-vaginal septum.- Rectocoele / ennterocoele.- Rectovaginal fistula.- Colovescical fistula / recto urethral fistula.- Intussusception rectum.- Management of third/fourth degree tears of the perineum.- Anal sphincter injuries.- The medico-legal implications of anal sphincter injury in childbirth.- Intra-epithelial neoplasia.- Rectal Cancer – the extended resection.- Gynaelogical Cancers.- Urological cancers.- Techniques for reconstruction of the perineum.- Surgery after radiotherapy.- Help – where is the urologist.- Help - where is the gynaecologist.- Help - where is the colorectal surgeon?