Jitendar P Vij

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© 2005, Editors

All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.

First Edition: 2005

Typeset at JPBMP typesetting unit

Printed at Gopsons Papers Ltd., A-14, Sector 60,Noida4

We are fortunate to have lived through a period of historic milestones, and the turn of the millennium. The last millennium saw dramatic technical advances in the field of medicine. The greatest single difference between women in rich countries and women in developing ones is in their reproductive health status, particularly the availability, affordability and access to the same.

The editors would like to sincerely thank the contributors to this book. It had a long conception period due to some chapters arriving late and the need to have an extensive editorial process to make the chapters uniform, avoid duplication and step down postgraduate into undergraduate knowledge. The latter process has made some chapters so different from the original submission by authors. We ask the authors for their understanding and acceptance of this process. The principal editor collated the chapters from the other editors to streamline the publication and would like to acknowledge the help and advice provided by Mrs. Sue Cunningham at St. George's Hospital Medical School, University of London. We are grateful to the authors and publishers for their patience in the production of this book. Mr. JP Vij, Chairman and Managing Director, Mr Tarun Duneja, General Manager (Publishing) and his team from Jaypee Brothers Medical Publishers (P) Ltd. need special commendation for the constant encouragement, in-house editorial work and production of the vast number of figures in the book. We would like to thank Dr. Shirish S Sheth, past President of FIGO and an internationally renowned Obstetrician and Gynecologist for writing the foreword for this book.11

Gynecology has always been a fascinating subject looking at the health issues of a female from birth to the menopause. This book takes the life cycle approach starting in sex differentiation, abnormal development of reproductive organs to pediatric and adolescent health. This is followed by menarche, menstruation and menstrual problems. The issues related to contraception and subfertility are dealt with in detail. Sexually transmitted diseases and pelvic inflammatory diseases are described followed by benign and malignant neoplasms of the reproductive tract. Menopause and cancer screening is discussed based on the current data and available evidence. There is little doubt that gynecological problems are increasingly managed medically and by minimally invasive surgery and where possible by outpatient procedures. Detailed descriptions of these are provided including the latest in technology.