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The current literature reflects a trend toward alternatives to abdominal hysterectomy for the treatment of symptomatic leiomyomata uteri. Precision in diagnosis is aided by new techniques in ultrasound and magnetic resonance imaging. Gonadotropin-releasing hormone agonists reduce tumor and uterine bulk; relieve symptoms of bleeding and discomfort; are clearly useful as an adjunct to surgery; and in some patients may resolve symptoms, thus obviating the need for surgery, at least in the short-term. Repeated courses or long-term therapy with gonadotropin-releasing hormone agonists remain limited by the potential risks associated with long-term hypoestrogenemia. Myomectomy can be offered to symptomatic women desiring preservation of reproductive potential without incurring significant alteration in operative risk compared with hysterectomy and with a likelihood of subsequent conception exceeding 50%. Endoscopic removal of submucous or intracavitary leiomyomata is clearly technically feasible with acceptable risk by hysteroscopy and with good conception rates thereafter. Laparoscopic removal of intramural and subserosal leiomyomata uteri is also technically feasible with acceptable perioperative risk, but the need for removal of small tumors and the safety of subsequent pregnancy after removal of large intramural tumors has yet to be put into appropriate perspective.

Objective: We sought to determine clitoral size in normal women and the possible effect of age, height, weight, parity, and oral contraceptive (OC) use., Methods: Prospective measurement was made of clitoral dimensions in 200 consecutive normal women at routine gynecologic examination in an office setting., Results: The mean (+/- standard deviation) transverse diameter of the glans clitoris was 3.4 +/- 1.0 mm. The longitudinal diameter of the glans was 5.1 +/- 1.4 mm. Total clitoral length including glans and body was 16.0 +/- 4.3 mm. The mean clitoral index was 18.5 mm2. Measurements of all diameters were normally distributed. Age, height, weight, or current use of OCs did not influence clitoral size, but parous women had significantly larger measurements., Conclusions: It is possible to obtain useful clitoral measurements in the office setting. Parity influences clitoral size, but age, height, weight, and OC use do not.

Aberrant breast tissue may occur anywhere along the embryonic milk line. Only 17 instances of breast tissue of the vulva have been recorded in the English literature between 1900 and 1976. Review of these cases, as well as features of the patient herein reported, serve as a basis for presenting a clinical profile of this interesting entity, its potential complications, and a rationale for appropriate management.