Gynaecology and the World Wide Web

How should you start searching for websites in the field of gynaecology? Of course, you could start at the FIGO website (http://www.figo.org), where there is much useful information. FIGO has 101 member societies, of which about 25 have their own websites at this moment. This is one way to begin, especially if you prefer information in your own native, non-English, language. Or perhaps search engines? A search for the words ‘gynaecology’ or ‘gynecology’ produces many thousands of hits. Search engines, however, give the impression of making very random choices. 

In order to overcome this problem you can log onto OBGYN.net (http://www.obgyn.net). Launched in September 1996, OBGYN.net is the gateway to information in the field of obstetrics and gynaecology. This is one of the few websites that also translates content into other languages, like Spanish, Portuguese and German. In September 2000 more languages will follow. On this site are several sections, each devoted to a gynaecological subspecialty. We will now take a stroll through the English language websites, calling at the different subspecialties:

Infertility
The top infertility website is FertiNet (http://www.ferti.net), launched in 1996. The content is arranged in a magazine format, changing every month. The character of the site is mainly European and has a clear link to ESHRE, the European Society of Human Reproduction and Embryology (http://www.eshre.com). There is a very active ‘Journal Club’. Although five years ago their trade mark was difficult to find, nowadays it is obvious that there is (sole) sponsorship from Aries-Serono.

OBGYN.net has a fertility section: http://www.obgyn.net/infertility/infertility.asp . Following the links from here you come to realise that many sites are advertising IVF, like Marc Perloe's IVF.com (www.ivf.com). This is less the case with http://www.asrm.com, the more neutral site of the American Society for Reproductive Medicine. This has a section (requiring a password) for members and an open section, including many FAQs (‘frequently asked questions’) for lay people. Also for the general public there is the website of Resolve, the National Fertility Association (http://www.resolve.org/) or more specific sites on individual topics, like endometriosis (http://www.endometriosis.org/index.html). As for many topics in this field it is not possible to provide an exhaustive report…

Contraception
Here most sites, including some pharmaceutical company sites like those of Organon, Schering and Ortho are designed for the public. Recently, www.femalelife.com  has been announced for the last quarter of 2000, as a comprehensive, multilingual resource of information about general contraceptive issues for women.

Sites for professionals seem to be very rare! One of the good exceptions is http://www.ippf.org , the site of the International Planned Parenthood Federation. The country profiles are very interesting (http://www.ippf.org/regions/countries/index.htm). These profiles have been produced as a collaborative effort between Family Planning Associations affiliated to IPPF and IPPF Central and Regional Offices.

If contraception fails, considering an abortion could lead someone to much polemical information on the Web. The International Society of Abortion Doctors (http://alpha.nedernet.nl/~ngva/isadindex.htm) gives apposite information without too much political colouring. 

Menopause
For the North American culture the first port of call is the NAMS site (http://www.menopause.org), where the target audience is professionals and patients. The OBGYN.net menopause and perimenopause section (http://www.obgyn.net/meno/meno.asp) has a more global view. The active Forum, where specialised correspondents answer patients’ questions, is very interesting. The focused company websites, like for instance www.womenslifestages.com address women of all ages. This site helps women of all ages to understand menopause, osteoporosis, but also contraception.

For doctors there is the Doctor Guide to the menopause (http://www.pslgroup.com/menopause.htm). And a real jewel can be found on the European HRT Network site: the full text edition of Practical HRT (http://www.hrtnet.org/prachrt/toc.htm). This comprehensive and up-to-date textbook covers many aspects of oestrogen replacement therapy. The website of the European Menopause and Andropause Society will soon be up and running; the URL (i.e. web address) was not available at the time of writing. 

Minimally invasive surgery
Again beginning on OBGYN.net (http://www.obgyn.net/hysteroscopy/hysteroscopy.asp), this section covers hysteroscopy, laparoscopy and hydrolaparoscopy, and works in cooperation with the AAGL and the ISGE (the US and international societies).
Images can also be found on the ISGE site (http://isge.org/pic/content.html) or in Endosurg, a French website (in English): http://www.chirurgie-endo.asso.fr/endosurg/index.html. Highly focused on hysteroscopy is the Brazilian website of Dr Afonso, which claims to be ‘the first world site’. This site (http://www.histeroscopia.med.br/hysteroscopy.htm) has a great deal of information as well as pictures.  For those who want to surf ‘on their own’ the following links pages are a tremendous starting point for accessing many pages of clinical information: http://www.obgyn.net/hysteroscopy/links/clinical_links.htm (endoscopy in general) and http://www.obgyn.net/gynlap/home.htm (laparoscopy). Guidelines on endoscopy are provided by the Canadian Society of O&G (http://www.sogc.org/SOGCnet/sogc_docs/common/guide/ library_e.shtml) and on many other topics, including:

Urogynaecology
The International Urogynecological Association (IUGA) site (http://www.iuga.org/) has some fairly dry information about the society, and a link to details of their annual meeting, this year in Rome. The links page seems a little disappointing, however, with only two links.

The newest OBGYN.net section (http://www.obgyn.net/urogyn/urogyn.asp) contains original papers, congress videos and links (http://www.obgyn.net/urogyn/links/mp_links.htm). It is fair to mention that the links are very US-oriented. Among them is the general urology site of the American Urologic Association, http://www.auanet.org/index_hi.cfm.

One of them is to the International Continence Society (http://www.continet.org/). Patients who suffer from incontinence are in general very embarrassed and it is essential for them to be able to obtain useful information from the Web in a confidential way. They can find it in Drylife: http://www.drylife.org/. (The sites for children about bedwetting, like Wetbuster (http://www.wetbuster.com/) and Bedwetting Kids (http://www.bedwettingkids.org.uk/) are very touching, although they are a slightly off the topic of urogynaecology).

Oncology
Last, but not least, a section about oncology. We will not include here oncology of the female breast, although in some countries this is within the expertise of the gynaecological oncologist. (Some of the website details that follow were provided by Ko van der Velden, a friend and colleague from the Amsterdam Academic Medical Centre).

For oncology of the female reproductive organs the FIGO staging is very widely accepted. It is somewhat hidden on the FIGO website (http://www.figo.org/default.asp?id=32). http://www.apnet.com/gyn is the site of the journal Gynecologic Oncology, with shortcuts to related websites like that of the Society of Gynecologic Oncologists (SGO) and one where abstracts of the past SGO conferences can be found. Abstracts are available free, while a password is needed for full articles (PDF).
The (US) National Cancer Institute has a comprehensive site with information on cancer in general (http://www.nci.nih.gov/), while location-specific information can be obtained by clicking an alphabetical list of all cancers. Links to other sites are mainly to public sites on ovarian cancer ( no links are provided to the sites mentioned here). An interesting overview of ongoing clinical trials worldwide, subdivided by tumor location is available at http://cancertrials.nci.nih.gov/finding/index.html, while excellent results are obtained from performing a search on a gynaecological oncology topic using http://cancernet.nci.nih.gov/cancerlit.shtml.

The University of Washington Gynecologic Oncology Department site (http://gynoncology.obgyn.washington.edu/) and the University of Pennsylvania site (http://www.oncolink.upenn.edu/) feature tutorials on all gynaecological cancer locations. These (especially on the Washington site) include comprehensive overviews on treatment for rare gynaecological cancers. The homepage of the International Gynecological Cancer Society (http://www.igcs.org/) links to their International Journal of Gynecological Cancer (http://www.blackwell-synergy.com/issuelist.asp?journal=ijg).

There are two competing sites on cervical pathology, the American Society for Colposcopy and Cervical Pathology Web Site (http://www.asccp.org/) and the National Cervical Cancer Coalition (http://www.nccc-online.org/). Both offer patient information and educational material for professionals.

Epicrisis
Describing website URLs in an article in print has certain risks. Firstly, the site can have disappeared or changed dramatically the moment the paper is published. The second problem is presented by the often very lengthy URLs: they are difficult to type correctly. Consequently the author would very much appreciate any comment on the quality of the quoted sites or the (mis)spelling of the URLs being sent to hans@obgyn.net.

*Re-published on OBGYN.net with permission from MFI