SURAT PASEHDRA FADAT| GYAECOLOGVr 7 © Pubeoty , Precocious € Dela layed | on ® Menopause @ Menstruation < usGintyn @ Peluic In _Disoowe | = Sa\ Pingi tis = _ - © Dysmencavheea ® Retroversion. : : - i, _ © Genital Peclawe : . 2 © Infeohist i — ® Cesvical Ectopy : ; ig @ Ftoooid. SiRF Fok a 20 ® Endometriosis s: ‘Adenomyosis w © Carcinoma of cow!x » © Genttal Feotulae: 9-Genjtal Track Inyumies. ® Amenorshoeaq © ContracepHon i ® leucorshoea ® e@wPrevijus vuluae , Vvaginiomus @ tTaichomoniasis Mon@liasis, senile vaginitis @® Het, Pelwic Abscess ® Premenstrual syndrome @®@ Hysterectomy. Rockstar Pandya_ortrelegical ange! a Breas} Growth , | i % Pubic dimvGrewty 8 Axillary hair Grewty oo Growth Mr height s Mensa ation : - Genetic - Natdhon ~ Body: weight ) : | ~ PRyso Poysholegic ciate iQ ~ @xposuie te ight @ others. ndocrinciogy In pubewry i - Hyporhalame - Pralfary gonadal axl¢, - Mhyrold Gland. Playy Ache ~ Adrenal Gidnd ele fo pubesty |ee ee Me te called menarche 2 pede time fe 18 year. Grew = Grech ie mainly due fo — Gretottn Hestmone” — Sestrogen a Inguling ke growth Fader. read, “emgan changes _ : © ovary - change Shape , , Clongated to balkey oval shape : . — GNaginag - Thin epithelium to shaifed epith @valuq — More teactive to Steroid howmone @mongy pubis € labia minora: increawo gine ©ereast — ProliferaHon .of duct _ Prominent ‘ Round Sccas}. Tanner Staging ! = © Breast development Stage 1 - prepubestal sabe 2% - Breast budilingep. & it secondary mound of dicole” S - Adult Breast . =e (@©t Puytc “eee “peuclopmenh — Stage 2 - Ne pubfe anc = long hore Side of labia _majera a - Darker) cutled hatr eves tre _ 2 os MONSPUbIS, i & = Adu “type “hair covering Stage se = Aduth hale- wath trangulaw | erizeod disteibubon’ , fommon Disorder | —Precoctous » Pubooty ( = Belayed Pubes -— Menstrual abnosmalitos - omer .= Platina ; pulsatile | saxo tha rmackerist cl before: tne age oF e of e PStt Is due | to excess preducten oF gostrogen. a consti . pcre mare Te So. Intracranial lassi6n “Fraeno% i = Albsight syndrome obo bpaet om Prematuco thelaeche * fe a ~ Premature 9 puberche ~ Premature menarche . ~ Diagnosis. “= - x-ray Hand 2urirt fer bone Age - peluic Sonography © Seal xe ray - Ct- Scan Met Brat | “Treatment - Depends upon cause Medtoxy Progestrerone acetate Cyproterne acetate ~ Gnktr agaonist therapy i|. a Po Puberty j ee WEA He proasts HsOue: cand pabic h Ereeraioree nypegonadioy a — Gonadal “dysg sgenesig, 8 — Pure gonadal dysgenesis — ovarian ee © Hypogonadetropic hypogenadiem 7 - constitutional delay 3 ~ Chrenic i\ness — mainuiatien — Priimaig hypesthy cdism —& Anatomieal cause —Maulleatan dysgenesis 5 Tmperforate hymeo = Transverse vaginal — Treat - estrogen Aee. $0 etiology| _mengrruation sat atthe end of fe produckere _\ife due to loss. of _ovamian “fellilar 7 Locdulty ? Avg. eojee as- SS years, | Pedecinalony of climactosic 4 = —Hapathalane. =| pate, _gonetder! arig, 4 — + Oestrogen — — 4+ Andregen | =a “ah Poogesteacr ) = Gonadohophin ARSED Lip | “a L Joann _ Organ chan QS. Dovavies -— Smink in gine Lointled vbite Oratlopian tube - Atrophy | © uterug = smaller | © Vagind ~ = navewer toss of elasticity © Breast = Reabsoobed =, Hat en) — Atrophy changes — © loss oF musde tone. E_| | Bone Metabolisin ‘lose of bone masse by 87S ‘/ per yr, — 4+ Semtrogenee 7 — High asic ae re Tous) “‘cestregen wo — Atherosderesio, —menstruaten pattern peice | = to Mens PAWL = — Sudden cessation of mens = Gradual hy pomenowsheea = Trregulan wits: om estiniets | (excessive bleeding . : P Menopausal: sumption . — vasomoter Hor idol te 210 — Genital and urinary: dyspareunia — phy poychelogical Anxfory = Health ha2zacds . Oesteopsrasio Bfagnosi®. “cessation oF menses Fer consecutive 6 mon during CiimacterPc — Appearance of Menshudl symptem Hot Flush © Night sweats = vagina cytology 4 Oestrogen . — Serum FOH 2LH > GomtU/m) ‘Treatment © Non hormone Heatment - Nute?Honed suplementiany diey jut D. diet_Biephonpte _Tniazides. = Mestieceliany sigy aati ee rensrmutaios able _4 E cyclic” physiologic. uterine _ bleeding due | __te shedding of the endome ___ Oferticulas growth and AnesiIas @ Peimardial Felice _ c 4 ‘Gib Geimy cety so! f Ovonian cycle - Development and | ft maturation OF a Follide , 4 I | ovulation and formation of 3 Corpug juteurn © degeneration Consttet = Receuitment of groups of follicles - Yelecton of dominant} follicle (—) ovulation — Corpus lutem formation t= Demise of Corpus leteum , | | oases d+ Ovulation causes UH sarge , FOr Ice bon Stretching factor : ContracHon of micro muscle. ai — 2. Corpus: \utean - 7 Ater “evulation= the | “os ruptured? Graaflan follicle develops “Pooliferation Pa Nasculersisation: _ a Makiatien 3% ao & — Regrespfon . © ~__& Endometrial cycte a \, Basal 2one 2. FancHonal 20ne — Regenerative: — Prolifevatue ~ Seaetorg —Menstruahon , Mechanism of menstrual bleeding . - Stasgis oF Blood - spasm oF arterioles — leads to Blamage anterodar wally — Phase of oelaxation ~ Bleed’ out through Damaged Loally — Bleeding occur frory broken actevien veins and capillaries ~ Blood Coagulates \n aterine couity he — fenstrua) Flow Stops o Prolonged vasoconsFetion , Sie_Menstru al J syn mMptome, $. _ Colicley palin = = Groustty, a Aeyelcpeocnde! Fallicle -_ ovulation ! - maintenance & demise of corpus luteum 1. Beging as “pink | discharge 7 @ end 2 gtd day wed Danke . _& Dysrmencerhoea 5 Pelute discomfoest « Backache 7, Fullness of Breast © ultrasound __- Sono graphy is widely used In Gy nacolegs ae Tranabdoeminal (TAD) Transvagincd CTS) iene Seoegraphy CTAS) “— Done WH» dinear> er -ciryflineac t ees transducer 2S —3.5 MH TAS require Fall bladde>. Ses used feo Jame mawes7 ¢ TTranetaginad _soncqraphy ~ Cts) 195 3d —Pone Wik probe which ff “placed” te the = There no need of Fall bladder “uses use fn Invent wove ia ce & proufde evidence of ovulation , © Cepect cespech ming | oF evulatce @ Detect EClopTc pregnang. & Evaluate Pewic mass, & oncology ASSESS Moatigant tumour. € Endometmal disease | Gs Senshystemgmapay § © To \ecate missing Tuo © concgiaphicallyp gutded procedares ,ae: Belld, Silicea, sulphur - —— aay i _ Pelvic Ipflanomatory Disease - PED is Disease ef upper genital tack, TE Is the infection and joflammation ef the upper genftal tack omgans typically involving. fallopian tube , ovaries 4 surrounding Structure i 4 — —________}- on — = | €pidemiology i incidence of peluic InFO Is | [ —okse due 4o_oise in Sexually > _ transmitted diseases, 5 | Rise factor {= Menstrehting Aeenagers ~ Multiple sexual pavinerd ~ Absence of Use oF conticageptive ptl], = Previous History of acute PTD | = TuD wee, / ~ Area with high prevalence oF sexually transmitted disease , | Merpbiclogy causative organise | © N. gonessheea © chlamydia trachemerti ® Mycoplanma Hominis , —@® C.col? ; 7 Sexually hansmitted vectom — Relax: of menstrual bleod. — Mede oF _mffection, | _| | 2“ao — ~ Deseruckion “of -eptrhotial calle (cilia 2 2 mictovil|? “C/E Symptoms; : aye — Soy © lower abdominal and pelvic: pain _® Pain Dal} and Acute iq Nabare ® fever , headache ® Trregulas 2 eacossive vaginal bleeding © Avnosmal vaginal discharge © Nausea vomit tH ag @ Dyspareunla Signs, ® 1 tormprature © abdominal tenderness, ® Abncomal Vagina) discha te @® Pas may found iH Dichaige foo uterus for Staning yt Pus for exci, Blood exam, _ LAPATOSCOPY — Hyperaemia 2 oedema | pus in pop,Cea eee cl a } = ie i | oo Se PHeaemia. otal Dey Dysparcania _Ttnfeattity hone potuiic | _ToRammation, Risk ¢ of €chople pregnancy. “Treakment =~ Tnctease public health enodiness” a Prevention - oF OTD = Use oF contracephives, Es | = Contre): Tar ‘ a 4 | = Prevent ink? 4 drugs 7 4 Doxycline loomg @tO ery thromydne TeHAeyline .eo Hepaw sul, Belladonna - __. Sep Salpingitis. — Enfection of the fallopian Sal Bog itis. a pears = —- Tafection Is usually pelymicrobiad_in Nature ~~ Both the tubes ly affected . _- Both the tubes are usually anecter a ee meoblology = Causative organism, - “Ost 7 Gonococens) 8 4 Br Mycoplasma - piliia) es eo . chiamydia trachomatis _ ®@Megeric 4 Streptococcus, €-coli n Bodeseids TagGlFS 4 ~ @ Tubercular 3 Mycobackesiunn tuberculosis. mode of TnfecHon @ 91D - fromm Sexually confech - © Pyagenic - {rors uterine cavity . ® Gonococeal - inf thiough continut ty and - Contiguity : © Tubercalar + Blood Streary | Acute and chronic. ‘Treati— AS PID. Acute abdominal peiin | Face Flushed — Palse Rapid | N fempratute | Tenderness| ee s\o | eS Dysmnenowe heed Def Dysmenovs heed \iterctl ly means Da TU | “menstruation, : Phpaqice — Types -- © Paroarey. ! © seconderee . | @ Primary Bysmencirheed — tohere there eis | No identiAable pelvic | pattelegy — Cause : _4 ® Ps vektivemaite: factor - due to tengion | es I 1 © 0s: oo) Anxlety . © Abdnormal anatomical and funcHonal aspeck_ _ of uterus | a — Narrowing of cervical cannal, P | = unequale development of muttestan duck dob ~ Uterine hypoplasia , L © Increased. vasopressin Telase. 1 C/R- Pains Foo heats befdee. onset of Pmendraatior Pains are spasmodic and confined to | on lower cbdomen, I = Nauseq vomiting Harigue , dtavshooa | headache , eh Analgesics & antispasmodic | Ee© ) Secondaay pysrs . As pois pathelogy: ‘presend e “eae. o reasiog, ONSIO to elu? Sue a CHU _Tae A 0 pelvic. Pe encree ca: vaseaoty An, pelvic Organs _ Faing 3-5 bday peters ames! 7 Relies oy viecding coe = be Pain dull , SEwored pack 2 infront Aheraps— Magphes ,pulsahlla —, verajoum Ab Colecynty . io ~Colocyorh — severe neuralgic py, left-sided affected. ee Gredt resHessnesp, Buoning paing , Better bi howd pressure 2 heck , priccing £ Hashing Sema ton Dysm with copious bleeding . < evening » Cd -Anger > Heod pressure , bending doable , gSelond, ~ Gongesue dysm, , Severe \ntlamahion - _Maginc te dry and hob: | Dragging pains “Sudden £ Njolent ersek. eS X 7 ee “corpus “and ceruix are in line and the | whole organ tame. backeocids in Rei to leng axio of sla cane, ; “RetroFlevion tm means ». Rendag _backeoatds of = Gorpus.s ic on cer x , | Degas oe —___ @ Froph Degree 3 fundus is vestical and — a pointing towads saeral Promontory . po — a ®@second veges + fundus ties in sacral hollow third Degree > Fundus lies below leuel. of intemal oo. Cause - = © Developmentey |— > = Bue to devel. Defect _¥ — lacie of tone of uterine muscle. — Sheot NACA , © Acqui red 3 | be | 3“Puerperal - Subinveluted bully teu e |2 Prolapse | - oe 7 4 Tumour — Fforoid beget) ——“u Beluic adhesions, [ eluic adhes e “O/F — Symptoms i | 4, Ohrenic. premenstraal pelwié pain Se 2. Backache OF Thor swagecy Ss 6. Dys areunia i me , a. Tofeort ity ee _ Signs - ania ee a 1, Coouix directed apwards 2 foowards a. uterus felt threygh. postevto o- Forn'ix = Menstrual abnosmalities : _ Dysmenosvhoea [= chronic pelvic pain ior pyspareunia 5 “Treal- Peessary Surgical) . — | Pca | iPodophyllum , sepia, iar Hg eee oe a : | Genital Prolapse . | = Descent oF Vagina) usall: “in “ules, Fe ee Supports of ov of uterus | = Endopeluic fasia — Round ligaments ~ Broad sections Senger are = Comics ~ vagina) Junction. - Pelvic cellular Hsstes, ~~ b. Suppe 2 ae el ‘Suppoob = Pelvic cellulas Hesse Bladdex —_~Endopeluic Faster, — pewsinadl Body. ~ Aetiology ~ othe ce prolapse occu due to cocakness of the Structure Supporting the organ to position. : “A. Nagingd delivery wily inyary 40 | Supporting Structure fs common cause. _ @ everstreetching of aterosacral \igarnents, = Premature bear dewn before Ful | del dilattaHion of covuix,_ of cervix, S- Downward pressure em uterine | _ |e Congeri}al abnooral\ Hos. nica’) Types ce Onaginad CD Une "Anterior wat) > “= ulero-vagina) tystoceie ~ congenial , b. uretnrocele Ce CYStO - UIeHh, Posterior wot a Relaxed pesineus bh. Rectocele & Valult prolapse , Rymphom, Feeling oF someting Coming dawn , — Bacleacho — DITiculty in passing arine = Painfal micturition _~ Retention of urine | Treatment © Preventive | — effective Antenalal care.: eo — Adequate Intranckel care : _— Adequake Postnatal care, > for ‘Colpowrhaphy. oF enterocele 7O% | : — Pelvic Poor repair oe 1-19 Nlaginal Hysterectomy a ae POS oF Naat “Proldipse | ot Shaning_ | Pouring ; 5 P= proke = Painless: ead, checell | Dehydration lg 2) peoree 7 |Prelapee :au “pefor, —__ ©Primacy | lnfeohtity don haue newer concelved. aS __ ©secondary Jofeotitity, ‘indicates! “previous . Pregnancy but fale 0 concelue — _Subsequenhy Pause - tn male _ 7 DeFrechue Spemategenests . undescended testio 2 Momps orchitts, 3B, aenerc 4G, Drugs, Heavy smoking , Alcohol S- Testicular faliure » 8. Padiathon, —Falure to depesite SPEIDH high in the Vagina Ccoited preblenno) 1, Erectile dysfunction 2 Gyaculatery defect 8, Hy pospadias. 4, Loss of spermy moti Ls —Gires in seminad uid 1. High of loco vol® ayaculcte& lew Fructose centelin 18) undue viscoofhy . a Tobstudton to the eleront ducks. [ ® Tr Fernale i a bys 92 4 4 = Pelvic causes eee eae , + Endometnasle. a % Adhesiong, __# __ ~ Uterine cause Ay Chronic. Endomotriesis 2. FPbroid : & Congenital malformaton, = Cervical factor A chronic ceric} ts & Tmmulogical factor = evarlan cause | —— oA Anovulaton poh pes Corpus lubeum lef | IOSUFTFCIEN GY : | Tovestgaton Male - History | exam, Blood , utine , Semen,Hermene estimate aS AE ginal career? female —. History surgical MG DIAC_ HAS j EndOmy Biopey 2 RUIN OL —_—— — “Treatment - Assurance. =e ypaloi Aveid Alcbohol +, 9mMOKINg Totrauterine insemination | Trvitto ferhlization sai fila : Agnus COShUS | Sepia / Plahna Sale niumFo got) VOD. a TOM): \ __ Cevvical €ctePy (EROS | ee der - cerviccu ~ echopy io condition "here _ [the Squamous epitheliany of _ectow@aulx is] replaced by columnar opitheliaian, ashich ig Continou® cwolly endocewix, ate’ is net an eauler. 4 Apion =n ee | fongenital — congenital errasion toappearg ee pude puberty, L tf a9 “Acquive | d= “Hormonal — High eestregen [ _ InP? - /F Symptoms, =_ a lesion mneuy be csympromertic a > Muceid Vaginal dischauge | - 7 Infechoo a ~ Contact Bleeding — Backache , pelvic Pain “Signs - Bright sed areq . | lesions may be SmeoHy " Diagnasio — confPemakon by Siopsy Colposcopy } - 1 4, (Treat = Thermal cautmiaation | Cryosurgery —y \aser vapenisadton~ = FPbreid- © Not only commonest “berbin _| sumone oF uterus | “out As commonest Rist factor - eae : ea - obesity » SMOtNG, Black Women “TTypest- © Body — ® Cewvical ~ Fpreids are mosty tecated in the Boss, oF uterus, and usualy multiple A. ThforsHtien! oF intramaral @ Subperitonecd or Subsewous | 6. Subrmucous = | —Ccomlced —, Intorstiiicd | % Subperitonec| | &. Polypoidal “Secendony Changes In Wbreid. 1, Degenerations G Tafechon Q. Atrophy 6. vasculae 6. Necrosis &, Sareomatous, igukiee |— — “tommon. in tumours with conneckiue “Hssu0 = feel becomes soft elastic. = “© tysiic degeneration _econrs Following 4 in” inte rst | Rbovide,_ — a ec ahier —4 _@ fatty degeneration | _ occurs at _SAOMOPASE - @eed degeneration eceums in large Foci” i _> torpour Show dark areas ~ Odour ie offen oh = Colour. due to eed cols Lb. _ ©Atrophy j 7 Atroplh changes OCUT FOI mMenopawe , > Reducton im sizo of tumour, “Necrosig of Hanuac | © Toe gains actass to tumour ] usually | happens Folly delivery or abostion) | se __ Oraswlae changes | ~ Bilataton oF veassely 4 es : 4y Sudden eclargment of rboeid cie- Pk are usually _Dullipareds . _Signé_a@ — menstrual abnosrsal Hee | | Fer seor) _ a [frr Bysmenowerhoeds 701) Fann Serge - Tofeott\ userus 10 —~= @lengatlon af Uterine caviky 9) MOF At ge = Menowshagia Ey: dyspareania, 7 Anenulation , Salpingitis, ee ee |- Endomeimosio, _ 7 — “Toy- Usa, meF , Laproscopy , Hysteroscopy . “Tregt- Symptomatic a Myomectomy Hysterectomy Enclo scopic surgery : site : © cenical. = © Anterior cesuical — Retention of urine _ @ Posterior ceruical + Smyp. of constipation . — @ lateral aervicad Hacmomhoids , cedema lege iB) conta cemicad 7% Produco gladdes symp. —rrcilmaet > Myomeclormy , |Endometciosts - the presence of functioning — “onset Glanis and Stroma) in sites other than “uk@ind mucosa is called cerdornetsiosis, = is not neoplastic. cond) » Bab: _ te possible . ee About lor ie Increasing in both real. apparent tory, St Abdominal , Cxtraabdeminal ¢ Remote — © Abdominal &— 4 | o — confined to abdominal ‘ru ca [- — oVasy , pouch of Douglas. 4 ~ Uterosacral ligament 1 : | | — Broad Wgament | - Rectum , pelvic lymph Nodes. ~ ©extra Abdomina) | — Abdominal sear of hyster— it otomy, 4 — €e6 Caesarean secton, = Tubectorey t myomectomy 7 Episitomy scan — vagina and cowix,-Reura , Jungs”: io Ry or Deep Nssute of areagy € Anighs, ~~ Pathogenesig te 1, Pelulc endomet «9 — = parograte giraHoD - — Coelomic” “metaplasia — & Abdominal viscera: = coelomic Metaplosia. ia — Beclouaginal sephaw piel) neal od S| Un bilicnd ye oie 7 & “Abdominal scar = Tmplantation a __efisfotomy gcar L oa Naginad ,comi x ~ &, Lymph Node - Lymphatic — & Gangs, pleura Skin _—* Nenous : : ee | Newes , Lymph Nodep SYMHED , Microbiology & They are emett| black dots | %o called pocoder bume | - Bluish colourctone. can = fmicroveaphc _-enclomernicct Hype present -ae Symploes wet “have NO _Sygmprern® aS 2 125%0 O_ more _ than SOD _ pains @_SBDysmonowrhoea © Abnormncd menstruation oe Toft (40-60%) oP © Dyspareunia, | @ Pelvic Bain » Abdominal Pain ® Dysuaia , raomabunic _ © Painful defecation ©, Diatrhoea © veciad_ bleeding & melend. _ @Signs.— ~ ®© Powic tonderess, Investigation, ‘= | Ulta eines ea eT | mpt : la pawesc p : laparctomy, f. @ S Biopsy i Complications i Tofeotli | i Ruptare — checolate ey nh Omasy may Fert lowor abdomen ,_—Tofectiod Chocolaye Sygh _ a Toreshinal, dpshruckion ureteral obstruction ! — Renal. Infection , 7 Anovutation , “Treatment orf boty __To_improve feviflity ‘To _preveot recunvence __ Encouraged | to conception Hormonal Heatmenk. Drugs, — nlaoqull = ypola nit Seviregen , Pregemragen Danmar] Sugary Pay laparoscopy [conventional laparotomy Seytuchon by laser or resecHon, @ laparoscopic Uferasacral Nowe a ablation aa 8. Bysterectomy coith Biladeral Salpingo - Copharecomy _fherepas — Phosphorus , Sabina , Geyenta [Oe eea “ingrowth ‘oF the cendbmekdaine both Tae and Stroma components, directly \nto_the —_ myometsiuns _ Causes - Pepeitied childbiotho j fetes Nigovous cureHage | Excess of - Cesttageo | Peluic endometricsig, Pathology = Hyperplasia of myomersiany : Choice) features | — PA U9velly PareuS Age € a@ 7 GO 4 Menorohagia - Cxcessive bleeding & Dysmenosrhoed — colicky paln 8 Dysparseunicl Signo - Hypagasinfe meu | Cnlargment of uterus, — TovestigaHon, ullrasound colour Dopples (tvs)Treatmen} — --pazial Regection | s : : a2 Hysterectomy OM | = = | mt {{fr - Se EEE — eo Ts ead ——— T ae | =De gee cancor_ ee een “disease e | | Different scregoing - _ diagnostic end _Hherapoutic. ‘procedures’ are effectve , (= Cancor ceux ie mosh “common eancer in Women tm* J year. ___ Tneidence +— » ~ Most in developing countmes — > Cetulxy moot Common matligneaney , | Examination! — Exephytic masses j rea: lcorahive lessions InfFPlirahue grocOHy , | —Mede of spread: 1. By direct extengion 2 By lymphatics 8 By Blood stream a By Direct tmplantaton | 1,| By direck extension '- Growth Spreads directly te adjacent Stricker | ~ vagina é otetus,ana cx Aymphatics “By “paramernal | =a Internal MNiac nodes , Sbtyratoc Cxlemal iliac Nedes oe No ae aaa ee 6, By Blood steam !— Blood ‘borne a 1s ‘te et By, Direct mpl antation | = “Direc nsdn no = | “> of cancor celle ot operation. Vey rare. “Sages_ef carcinoma of ceouix 7 ~ © Stage © —cardooma insta ~ © Sage t > Carcinerna SHieFly, confined _ ee tO COrulx, Be Ta > Preclinical carcinoma of coaux | Diagnosed only by micrescope , P34 | Tp 4 lessions of greajer yer" | Dimensions _ © Stage the Carcinoma extend cewix but not to peluic coat] | Carcinoma involves vagina , © Sago = Cardinoma extended pelvic | oat] — © Sage — > carcinoma extended beyond tho trae pelvis bee lacs,= fe Sage. Wo" = Spread me) gts! _rot eyo adjacent org | Stage Wb - Spread te Tara _ Diagoosio. _Bopsy I Po Colposcopy oo @ 2 tystescopy | 2 : Third venous “pyelography j E 2 Proctescopy . : —_Sympt. — Tregular vaginal bleeding elfensive Niagincd discharge = : Pelvic palo, vo Dysuata | Haermatunia | Reckal palin | Bleeding pey BECHIMD , Treatment} | Lh sugery ~ Radice) Hysterectomy 2. Radlothorap | a Chemotherapy, i Therdps - Catbo Animalig | Niitc Acid. me | my — Thya , Natu cards — , Todury,yer nS | | Genital fistrlac _ Deke Abnormad communication ber athe urinary, either | accquired oc congenita) mes involunteny escape of uring Into Hhe vadina “Typagi= 1. Bladder - a Vesico Niginal : ico -urernro ~via Hoag? Qa _ do. ats cae Vesico = utedoe de _Nesico- Comic i “arerhro _Nagi incl 9) Grohra 8. Uretor a. urebero - vagina) bs ureterd -utevine | ce urefero ~cozvical , TNE gIco = Viginad Is common among ther, — Nesico -Niginad Fistulas Cyr) Def) The communication ber the bladder — £ vagina and urine escape inbo~te_ ___Naging causing tue Incontinence . Ba —t Caused tt, Obstotaical _suses. =| Due to Ischemia or fell? trauma, | abstracted labour — ischaemic necrosis In infection — Sloughing > fistaler. meee: Sypostsagali he iz : oo “Tnvary “oa. _ ffs: eqni9 pemtavforclhAMmg iran sa)! i ~ Matignancy ” = Radiation 3 ' hte Historg,_ of aA iSicalt | labour. 1 = Countnous escape of urine ~ Escape of Watery Oischarge 7 Perineal tear may present - Amenorrheeda _ Tow CUR DYe test | Thiee swab test - | foo “Theat - Loced repair by Flap aplitting method, ain e vieie moves Geoital Track Injuies. =the 9c genital” rach 7g adjacent mpektic 01g organs pore Gugjected 40 Sprain of delivery =< =|The Injarg_ ts more in areas of Inadequate = Major ar Gynaecol ogic. problems. are = Genital prolapse | = Genito- atoarg 7 ~ Retiovagine! “Fistala, aryNaginel Secwe fos 94 sat, — Backache 4, MWehealth = COrnicitis, : pr > ~~ eld complete Pevineal Tear Copt yg Tear of perinead body involving the i — Xphincter ant externus with or worHnout Z_ [ involwemeot af He anarected mucosa is cated CPT, ij ; Achiolag | Migmanaged 294 Gage labo i Large Bab 2 face delivery 4. forceps delivery Precipitette Icibow , penned! Scam.1 v7 RS gre agua ly _primiparoud, = 7 Enability of of Held the Flakes and Aaecos, ___ = Borenese_over peotana) _ aegion, i= Absence of peringum = Lominkying_ of the Skin, en | “Treatment '— Proper conduct’ in and stago tabor ‘ ~ preuenHon of panes Inyaries 4 = pefinikve ae \s repaic of the | __ perineal tear col testorahion of perineod body. ~ Totestina) Adtiseptics, “Therapes — twice, Hypericum ;Amerrorrheea . we Amenorhoea literally means absence’ 2 TYPES, _. _. bop niArgenorrhoe.a, —— ——frsiflegical_—— = pathelogical 4 ximien. Fane a= ey BUTTER mee hide _Pienat Secondary Conceated Peal = “= @efere = During Pigg. ~—Ceryptomenass hoe) ——— a Dae, lackeiton RG] ct ) “po | —FollN Menopause Congenitial Ruhed sec Be ___* Cryptommenosshooa , __ = Tn eryptomenosshoca there is bleeding > peviodic shedding Ff endormeimum bleeding but Hho menstrua) bloods fails | to come out from genital track duc to _ Obstruction in passage . Lauses | _ © congenital — Tmperforale HMymen. Transuese vaginal Septun Atresia of vagina & coulx. ©. Acquired = Stenosio of ceruix Amputahon,r monhoss -__ Pain io ‘lower abdomen. See ae Lession in Nagind ef cemulx __7_Uterug S09 eolarged Treatment i Bitadion 6 4 Dilatahon oF cervix. Reconstructive, Sarge . _Croeiate focision ‘of HYyMen , af _©, Primary Amenorshoed, 4 7 “Def A young girl cohat hag not get menstrs uated by her 16 years of age to having Primary Amenowohoea | “= Normeul uppes age limit for menarche is. + years, | cause Disorders of Hypothalamo ~ Pituitary — ovamian axio, _ 7 Abnesmal chromesomal Pattern. __ 7 Development defect of Genter track . = Tes porforette hymen . le Aesence of catenme ~ Dysfunction oF thyroid £ Adrencd cater , ee aa SS r—r—“——OO—SC—se