D C Dutta’s Textbook of Gynecology Hiralal Konar, DC Dutta
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1DC DUTTA's TEXTBOOK OF GYNECOLOGY: including Contraception2
OTHER BOOKS BY THE SAME AUTHOR
3DC DUTTA's TEXTBOOK OF GYNECOLOGY: including Contraception
Enlarged & Revised Reprint of Sixth Edition
DC DUTTA MBBS DGO, MO(CAL) Professor and Head, Department of Obstetrics and Gynecology Nilratan Sircar Medical College and Hospital Kolkata, India Edited by HIRALAL KONAR (HONS; GOLD MEDALLIST) MBBS (CAL), MD (PGI), DNB (INDIA) MNAMS, FACS (USA), FRCOG (LONDON) Chairman, Indian College of Obstetricians and Gynecologists Professor, Department of Obstetrics and Gynecology Calcutta National Medical College and C.R. Hospital, Kolkata, India One time Professor & Head, Dept. Obst. & Gyne., Midnapore Medical College & Hospital, West Bengal University of Health Sciences, Kolkata, India; Rotation Registrar in Obstetrics, Gynecology and Oncology Northern and Yorkshire Region, Newcastle-upon-Tyne, UK Examiner of MBBS, DGO, MD and PhD of different Indian Universities and National Board of Examination, New Delhi, India
4
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Textbook of Gynecology
Enlarged & Revised Reprint of Sixth Edition: November 2013
9789351520689
Printed at
5Dedicated to
The students of gynecology past and present6
7Preface to the sixth edition
This widely acclaimed Dutta's Textbook of Gynecology has stepped into its sixth edition within a span of twenty three years. Since its predecessor, each area of gynecology has evolved substantially due to the concurrent progress in the field of molecular biology, technology and imaging. The amount of knowledge to acquire and skill to develop by the students, residents and clinicians are enormous. Retaining the basic objectives of Dutta, for his textbook, this edition has been revised extensively in the light of current wealth of information and for the need of our targeted readers. Each chapter of this book is authoritative. Consistency and uniformity with updated information in all the chapters is a special feature of this text.
This edition has been made more user-friendly in terms of presentation of text matters, graphics, design and use of different color codes. Color code helps to highlight the core knowledge (must-know area) and also to present the high quality photographs, anatomical drawings, and imaging studies. The text has been enriched with tables, diagrams, boxes, charts, and algorithms which could be reproduced easily. Key points at the end of each chapter are for quick and easy revision. The state-of-the art in Dutta's text lies in the presentation which is simple, lucid, clear, and concise. Above all, it provides a balanced distillation of evidence-based information upon which a student, trainee resident, a practitioner, and a nurse can fully depend.
Chapters on basic areas (chapters 1, 2, 3, 4, 9), reproductive endocrinology (chapters 5, 6, 7, 8, 16, 28, 31, 33), menopause (chapter 6), diagnostic and imaging technologies (chapter 9), pelvic infections (chapters 10, 11, 12), oncology (chapters 22, 23, 30), urogynecology (chapters 24 and 25), contraception (chapter 29) have either been thoroughly revised or exhaustively rewritten. New topics, for example, adolescent gynecology (chapter 32), sexual dysfunction (chapter 33), gene therapy (chapter 30) have been incorporated. Chapters in general gynecology 17, 18, 19, 20, 21 have been extensively updated. The chapter on pelvic organ prolapse (chapter 15) has been rewritten, based upon the latest concept of pelvic anatomy and the ‘new’ concepts of repair. Operative gynecology (chapter 34) is meant to provide the basic principles of commonly performed gynecologic surgery so as to guide an apprentice. More emphasis has been given on case selection (indications), principal steps of operation and the complications. The chapter on endoscopic (laparoscopic and hysteroscopic) surgery (Chapter 35) has been rewritten, as it has gained its place to a large extent.
The chapter on practical gynecology (chapter 37) consists of several hundreds of questions along with answers, explanations and high quality photographs and plates of imaging studies. This chapter is designed to help the students in their preparations for the clinical and oral parts of the examination. The self-assessment questionnaire having objective structured clinical examination (OSCE) format is to improve the clinical competence of the students. The total information given in chapter 37 amounts to a “mini-textbook-cum-color atlas” of gynecology.
More than 470 figures, photographs, sketches and drawings have been incorporated.
Considering the vast amount of scientific information and the progressive research, it is practically impossible to limit the subject matter within the few pages of this book. Arrangements have been made, through electronic media (website, e-mails) for the readers who wish to know more [highlighted in the text ‘more information’; ‘ask the author’]. Informations regarding examination situation (theory, viva-voce and multiple choice questions and answers, clinical examination procedures, operation video clips) have been provided through these electronic resources (www.dcdutta.com/www.hiralalkonar.com).
My aim in this book has always been to help the students, residents, and the clinicians to remain with updated the knowledge that has passed the test of clinical relevancy.8
The editor has many distinguished persons to thank for their efforts in updating the book. I have consulted many outstanding teachers in the profession, a multitude of eminent authors and many current evidence-L studies-the legacy is gratefully acknowledged. I expresses my sincere thanks to many of my esteemed colleagues throughout the country and abroad for their valued suggestions, criticisms, and contribution of photographs (duly acknowledged). I acknowledge sincerely the support of all the students (undergraduate and postgraduate) of different medical institutions in this country for their opinion and criticisms that have helped to improve the text. As before, I welcome the views of students and teachers who regularly write to me offering their suggestions and ideas on my e-mails: h.kondr@gmail.com; h.kon@vsnl.net.
I am specially grateful to Dr K M Gun, MD, FRCOG, FRCS, Prof (Retd) for his contribution on the topic “Amenorrhea”, Dr B N Chakravorty, MD, FRCOG, DSc, Prof (Retd), Director, Institute of Reproductive Medicine, Kolkata, for his contribution on the topics “Reproductive endocrinology”, “Infertility”, “Intersex”, and “Hormones in gynecology” and Dr A Mazumdar, MD, Prof and Head, Dept Radiotherapy, IPGME & R, Kolkata, for his support in revising the chapter “Radiotherapy Chemotherapy” in gynecology. The editor wishes to express his sincere thanks to Dr Subir Kumar Dutta, MD, Professor (Retd), Dept of Pathology and Bacteriology, University College of Medicine, Kolkata, for the microphotographs depicted throughout the text.
Dr A Roy, PhD, Professor (Retd), Dr (Mrs) S Ganguly, MD, RMO-Clinical tutor, Dept of Obst-Gyne and Dr Chandrachur Konar, MBBS, deserve special appreciation for their sincere help throughout.
I am extremely grateful to Mrs Madhusri Konar, MA, BEd, for all her insightful secretarial accomplishments in support of the book through six editions.
Lastly, I am grateful to all who have taught me, most of all the patients and my beloved students.
I do hope this comprehensive textbook will continue to be an immense educational resource to the readers as ever. According to the author's desire, the book is, therefore, dedicated once again to the students of gynecologypast and present.
Preface to the Enlarged and Revised Reprint of Sixth Edition
To keep pace with the continued research, development of technology and knowledge, Dutta's Textbook of Gynecology has come up with an intrim revision. Many chapters have been revised and updated depending upon the information available and the need of current clinical practice. Keeping in view the recent advances, a new chapter, Current Topics in Gynecology has been added dealing with stem cells and therapies. Contents and the index have been expanded for easy text reference. Information regarding different areas of examination situation (theory, viva-voce, clinical and practical examination including video-clips) have been provided through our electronic sources (www.dcdutta.com/www.hiralalkonar.com).
I gratefully acknowledge the help of Shri Jitendar P. Vij (Group Chairman), Mr Ankit Vij (Managing Director) and Dr Sakshi Arora (Chief Development Editor) along with entire team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for their professional guidance, suggestion and support in bringing out the enlarged and revised reprint of sixth edition.
I do hope this comprehensive textbook of Dutta's Gynaecology will continue to be an essential educational resource to the readers as ever.
P 13, New C.I.T Road
Kolkata 700 014
HIRALAL KONAR
9Preface to the first edition
Since my publication of Textbook of Obstetrics about 5 years back, I have been pressed hard by my esteemed colleagues and the students all over the country and abroad to write a textbook on gynecology of similar style to fill up the deficit. Initially, I was hesitant to proceed with the stupendous task but considering the fact that a compact, comprehensive and practical-oriented fundamental book in gynecology is not available to the undergraduates, I have decided to comply with their request.
The book has been written in a lucid language in author's own style. Extensive diagrams, photographs, and flow-charts (schemes) have been depicted throughout the text to give clarity of the subject. Due attention has been paid to project the fundamental principles and practice of gynecology. As such, more emphasis has been given on medical gynecology. But for that, indications, limitations, and principles of techniques of operations have received adequate consideration. The book is thus made invaluable not only to the medical students but also the practising physicians and students of nursing.
The author wishes to acknowledge gratitude to his esteemed colleague Dr N Chowdhury, MBBS, DGO, MO (Cal), for his contribution to the topic “Hormone Therapy in Gynecological practice”. Dr Santosh Kr. Paul, MBBS, DGO, MO(Cal), Prof Dept of Obst and Gyne, NRS Medical College, Calcutta, deserves full appreciation for his contribution in a lucid way to the topic “Radiotherapy and Chemotherapy in Gynecology”. The author has much pleasure in expressing grateful thanks to Dr B N Chakrabarty, MBBS, DGO, MO(Cal), FRCOG (Eng) and Dr K M Gun, MBBS, DGO, MO (Cal), FRCOG (Eng), FRCS (Edin), FACS (USA), for their valued suggestions as and when required and their contribution of photographs to enrich the text. I gratefully record my thanks to Dr Subir Kumar Dutta, MBBS, DCP, MD (Path & Bact), Prof, Dept of Pathology and Bacteriology, University College of Medicine, Calcutta, for the microphotographs depicted throughout the text. The author records his thanks to Dr SM Dali, Prof of Obst and Gyne and Dr Bhola Rijal, Associate Prof of Obst and Gyne of Teaching Hospital and Dr (Mrs) Dibya S Malia, Director, Maternity Hospital, Kathmandu, Nepal, for their contribution of few outstanding photographs to enrich the text.
The author expressed much pleasure all the time to the House Surgeons, Internees and students of Nilratan Sircar Medical College, Calcutta, for the help they have rendered in preparation of the final drafts of the manuscripts, check up of the proofs and compiling the index. Their help is invaluable and unforgettable and without which the book could never have been published.
The author wishes to thank Mr Biren Das for his exhaustive number of drawings and flow-charts which enrich the lucidity of the book. The author also thanks Mr Ranjit Sen for preparation of photographs (black and white) depicted throughout the text. The author have much pleasure in expressing his appreciation to Mr Bimal Bhattacharya, MSc, LLB(Cal), DSW, DHE, Lecturer, Health Education and Family Welfare, Post-partum Unit, NRS Medical College, Calcutta, for the patience shown in dealing with correction of manuscripts and proofs.
In preparing the textbook, the author has utilized the knowledge of number of stalwarts in his profession and consulted many books and publications. The author wishes to express his appreciation and gratitude to all of them including the related authors and publishers.
The author still confesses that as a teacher he has learnt a lot from the students and more so while writing this book and as such he could not think to dedicate the book to anyone else than the students of gynecology, past and present.
DC DUTTA
10Guide to use the special symbols
  1. Ask the author = www.dcdutta.com
  2. More information = www.dcdutta.com