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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.
In light of this, we are especially proud of the results of our most recent study (see abo-ve), 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 hysterec-tomy!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 oc-casion of the opening of our new Outpatient Surgery Centre and our refurbished delivery suite.
Latest FOCUS list of doctors, with the Tuebin-gen University Women’s Hospital being listed 4 times for:
1. Oncology2. Breast cancer and gynaecological tumours3. High risk births4. Prenatal diagnostics
Dear Colleagues,
Gyn-TelegramUpdate from the Department of Women’s Health and the Tuebingen University Hospital for Women
„Babyfreundliches Krankenhaus“e.V. (BFHI)
e.V. WHO/UNICEF-Initiative
Universitäts-Perinatalzentrum
Level I
Zentrum für gynäkologische Krebserkrankungen(DKG-DGGG-AGO)
Universitäts-Brustzentrum(DKG-DGS)
Zentrum für operative Gynäkologie und MIC
Zentrum für ambulante Operationen
Südwestdeutsches Beckenbodenzentrum
Zentrum für Endokrinologie und Reproduktion
A O P Z
ZertifiziertesEndometriosezentrum
w w w. u n i - f r a u e n k l i n i k - t u e b i n g e n . d e
August 2014
Dysplasie-Zentrum
2
Women’s Health is the focus of the scientific activities and exceeds day to day gynaecology which is influ-enced 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,
Women’s Health Research Institute University Hospital for Women
• Experimental gynaecology• Experimental Obstetrics• Translational Oncology• Prevention and health
services research• Regenerative Medicine/
Medical technology
Department of Women’s Health
Women’s Health Research Institute Obstetrics and Gynaecology
• Gynaecology• Prenatal diagnostics• Obstetrics• Oncology• Endocrinology and
Reproductive Medicine• Senology• Urogynaecology
Prof. Dr. S. BruckerMedical Director,
Women’s Health Research Institute
Prof. Dr. D. WallwienerMedical Director,
Tuebingen University Hospital for Women
3
Centre for
gynaecological oncology
DKG*
Pelvic Relapse Centre
CCC *
Endometriosis Centre
Level I *
Perinatal Centre
MDK Level I*
Breast Centre
DGS/DKG*
Minimal Invasive
Surgery Centre
AGE Level III*
UroGyn
AGUB*
Assisted
Conception Centre
RP*
Dysplasia Centre
DKG
Department of Women’s Health
All certified centres at theTuebingen University Hospital for Women, together under one roof.
4
ZertifiziertesEndometriosezentrum
Minimal Invasive Surgery for all endometriosis operations. Laparoscopic clearance of deep infiltrating endometriosis, including bowel resection. Site: Complete resection of endometriosis in the pelvis and rectum.Team: PD R. Rothmund, PD B. Krämer
Zentrum für Endokrinologie
und Reproduktion
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
Universitäts - Kinderwunschzentrum
• Hormonsprechstunde
• Kinderwunschsprechstunde
• Beratungen zum Fertilitätserhalt
• social freezing
• Hormonelle Stimulationstherapie und Inseminationen
• Zyklusoptimierung, Behandlung von PCOS, Hyperprolaktinämie und Hypothyreose
• IVF-/ ICSI-Therapie mit Weiterentwicklung zur IMSI NEU: Embryoskop
• Kryokonservierung von Eizellen, Fertiprotekt, social freezing
Endometriosezentrum
Universitäts - Kinderwunschzentrum
• Hormonsprechstunde
• Kinderwunschsprechstunde
• Beratungen zum Fertilitätserhalt
• social freezing
• Hormonelle Stimulationstherapie und Inseminationen
• Zyklusoptimierung, Behandlung von PCOS, Hyperprolaktinämie und Hypothyreose
• IVF-/ ICSI-Therapie mit Weiterentwicklung zur IMSI NEU: Embryoskop
• Kryokonservierung von Eizellen, Fertiprotekt, social freezing
Endometriosis Centre
• Hormone Clinic
• Assisted Conception Clinic
• Counselling on Fertility Preservation
• Social freezing
University Assisted Reproducezing
• Hormonal stimulation therapy and insemination
• Cycle optimisation, treatment of PCOS, hyperpro-lactinaemia and hypothyroidism
• IVF/ICSI with advancement to IMSI NEW: Fetoscope
• Cryoconservation of egg cells, FertiPROTEKT, social freezing
5
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)
Universitäts-Perinatalzentrum
Level I
„Babyfreundliches Krankenhaus“e.V.
(BFHI) e.V. WHO/UNICEF
-Initiative
Centre for Paediatric and Adolescent Gynaecology
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
University Prenatal DiagnosticsDEGUM Level III
Fetal medicineTraining and examination Centre
Jeweils bestätigt durch Re-Audit
University Perinatal Centre Level I, Baby-friendly Hospital
Centre for Rare Abnormalities
of the Female Genital Tract
6
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)
All types of gynaecological cancers (primary and relapse surgery). Team: Prof. S. Brucker, PD R. Rothmund, PD B. Krämer, PD A. Taran
Zentrum für gynäkologische Krebserkrankungen(DKG-DGGG-AGO)
Gynaecological Oncology Centre in the ComprehensiveCancer Centre Genital Cancer Centre
Centre for Gynaecological Oncology
Diagnostic Interventional
ImagingGynaecology
Pathology Urology
Human Genetics General Surgery
Psycho-oncology Systemische Therapie
Rehabilitation Radiation Oncology
Interdisziplinary treatment
1.• Development of an
individual treatment plan
2.• Individualised treatment
of the “whole” patient
3.• Monitoring of the
treatment plan
4.• Supporting
convalescence
Precise radiotherapy
Specific pathological
sample processing
Surgical treatment
Pelvic Relapse Centre
7
Intensified early detection and counselling for patients with a family history and coun-selling with the Institute for Human Genetics. Team: OÄ Dr. K. Bosse, OÄ Dr. I. Gruber
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 für hereditären Brust- und Eierstockkrebsim Konsortium der Deutschen Krebshilfe
Beratungszentrum für hereditären Brust- und Eierstockkrebs,
Konsortium der Deutschen KrebshilfeCounselling Centre for hereditary breast and ovarian cancer in a
consortium with Deutschen Krebshilfe (German Cancer Aid)
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
8
Zentrum für ambulante Operationen
A O P Z
Opening of our Outpatient
Surgery Centre19.09.2014
Zentrum für operative Gynäkologie und MIC
The latest integratively-controlled operating theatres with all medical technology and endoscopic innovations, including 3D-laparoscopy.
Surgery Centre, Tuebingen University Hospital
Operating Theatre of the Future
9
Number of patients attending the dysplasia clinic
2008 – 2013
Changes in the portio, vagina and vulva
Dysplasie-Center
Treatment of lichen,dyspareunia and vulvodynia
Care of dysplastic changes during pregnancy
Condylomata and HPV-associated
changes
• Competent advice
• Latest treatment methods and concepts
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
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
Südwestdeutsches Beckenbodenzentrum
Dysplasie-Zentrum
Continence and Pelvic Floor CentreGenital fistula
surgery
Sexual therapy
Nerve-protecting minimal invasive surgery
Sacralneuromodulation
Elektrode
Neurostimulator
Urogynäkologische Operationen 2005-2013
9493
6206
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
OPS gesamt Patienten
• Constant long-term treatment• With multiple pelvic functional
defects: OAB, stool incontinence, constipation, pelvic pain, residual urine
10
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 standardsUsing 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.
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.
Die neuen Kreißsäle der Universitäts-Frauenklinik Tübingen
A: Family orientated
B: Intensive care
Family-centred obstetrics and high-tech obstetrics
11
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.
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.
Streptococcus – an old acquaintance newly evaluated
Picture: Streptococcus pyogenes, CDC Public Health Image Library #211
PD OA Dr. Abele
OA Dr. Pauluschke
-Fröhlich
19.09.14 Tag der offenen Tür Universitäts-FrauenklinikTübingen22.10.14 Mini Airport Meeting Flughafen Stuttgart15.11.14 Endokrinologietag Universitäts-FrauenklinikTübingen29.11.-30.11.14 Mammasonographiekurs Universitäts-Frauenklinik Tübingen03.12.14 Niedergelassenentreffen Rosenau Tübingen 23.01.-24.01.15 Tübinger Airport Meeting Mövenpick Hotel Stuttgart23.05.15 Dysplasiekurs Universitäts-FrauenklinikTübingen
Term
ine
Tuebingen University Hospital for Women in the Department of Women’s Health
Universitäts-Frauenklinik TübingenPforte: 07071 29-82681 oder 29-82211
Private and Consultant Out-Patient Clinic08.00-16.30 UhrPrivate Specialist ClinicPrivate Surgery Appointments 07071 29-82212 oder 07071 29-86301
Surgery Appointments gene-ral/ Outpatient Surgery Ap-pointments/ Specialist Clinic Appointments (Gyn)Call Centre08.00-17.00 Uhr
• General Clinic• Genital Cancer Centre• Breast Clinic• Colposcopy• Urodynamics• Endometriosis• Bone marrow aspiration
07071 29-82224
Oncology08.00-16.00 Uhr
Day Clinic 07071 29-82209
Oncology Out-Patient Clinic 07071 29-82236
Gynaecological Oncology Tumour BoardUFK Tü Level 06, Small Lecture Theatre
Frau Gleich 07071-29-84809
Frau Breumann 07071-29-85099
Perinatal Centre00.00-24.00 UhrDelivery Suite 07071 29-8311108.00-16.00 UhrPrenatal Diagnostics 07071 29-84807High-Risk Antenatal Outpati-ent Clinic 07071 29-86250
Assisted Reproduction Centre08.00-16.00 Uhr 07071 29-83117
Bed management07.00-15.00 UhrEmergency Admissions 07071 29-86311 or 07071 29-82681 (Switchboard)
Case Management08.00-17.00 Uhr 07071 29-82226 or 07071 29-82681 (Switchboard)
Prof. Dr. D. Wallwiener Medical DirectorTuebingen University Hospital for WomenSecretariat 07071 29- 82246 07071 29-2202
Prof. Dr. S. Brucker Medical DirectorWomen’s Health Research InstituteSecretariat 07071 29-80791 07071 29-4663
Paediatric and Adolescent Gynaecology08.00-16.00 Uhr 07071 29-82255