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INTRODUCTION: Gynaecological disorders in older women differ from those who are in younger age group. AIMS AND OBJECTIVES: 1) To study the spectrum of gynaecological disorders in women above 60 years of age. 2) To emphasize on the necessity of establishing geriatric units for women to give better quality of life to elderly women. 3) To emphasize on increasing the different screening programmes for early detection and management of different gynaecological disorders in geriatric age group. MATERIALS AND METHODS: This was a prospective hospital based observational study and included 150 patients aged equal to or greater than 60 years. Patient demographics and a detailed history was taken. General physical and systemic examination with emphasis on gynaecological examination was done. RESULTS: A total of 150 randomly selected females aged greater than or equal to 60 years were included in the study. In the study the most common gynaecological disorder found was pelvic organ prolapse (44%) with grade 3 cervical descent being the commonest. The second most common gynaecological disorder was postmenopausal bleeding (30%) with endometrial hyperplasia being the most frequent cause. Other gynaecological disorders found were benign/malignant disorders of genital tract (16%); atrophic vaginitis (13.3%); vulvar lesions / lichen sclerosis (11%); vaginal wall cyst (2.66%); hematometrium (2%). Co-existent urinary disorders were present in 20% of study group. The mean age of menopause in the study was 44 - 47 years (42%) while as 33.3 % had menopause between the age of 48 -51 years. 18% had menopause between 52 - 55years of age and 3 % had menopause between 40 - 43 years of age. CONCLUSION: The spectrum of various gynaecological disorder in elderly women of Kashmir include pelvic organ prolapse, postmenopausal bleeding per vaginum, urinary disorders, benign/malignant disorders of genital tract, atrophic vaginitis, vulvar lesions, vaginal wall cyst and hematometrium. The absence of specific health care facilities for elderly women along with poor health education leads to frequent complications as these patients do not seek advice in early stages. [ABSTRACT FROM AUTHOR]

Background: Scrotal swellings represent a common condition in surgical practice although there is limited literature available that encompasses the multitude of scrotal pathologies in adults. Aims and Objectives: The study aimed to analyze the etiology, modes of presentation, management and complications of different types of scrotal swellings in adults. Material and methods: Over a period of two years 400 male patients with scrotal swellings of age 14 years and above were studied. All the patients were evaluated according to a preformed proforma including an elaborate history, a detailed clinical examination, routine investigations and specific investigations if any like scrotal ultrasonography, ultrasonography of abdomen, contrast enhanced computed tomography of abdomen and serum tumor markers. The post-operative course including all complications were documented. Results: Mean age was 40.47Ü0.67 years. Epididymo-orchitis was the most common cause. UTI was the commonest predisposing factor (n=152) and E.coli was the most common organism isolated. Out of eight cases of testicular tumors encountered in our study seven were malignant tumors amongst which one had a lymphoma testis. Two hundred and sixteen patients were operated. Jaboulay's procedure was the most common surgery done. Orchiectomy was done for all 12 cases of torsion testis, as all of them had gangrene of testis. All complications were recognised in the hospital and managed with good results except two patients who had recurrence of varicocele and had to be reoperated. Conclusions: A careful history taking and examination are usually enough to arrive at diagnosis in scrotal swellings, but ancillary investigations like grey scale ultrasound and colour doppler ultrasound are also needed to differentiate certain conditions. [ABSTRACT FROM AUTHOR]

Background: Several voiding abnormalities been seen to persist in women even after successful repair of vesicovaginal fistula (WF). Aims and Objectives: To establish the occurrence, incidence and type of voiding dysfunction in patients with WFs and the impact of repair of fistula on it. The fistulas were classified into type II (involving the closing mechanism) and type I (involving the closing mechanism) as per Waaldijk classification. Materials and Methods: Preoperatively urodynamic study was done in all 35 patients while in the postoperative period it was done only in 18 patients as five patients were lost to follow up and twelve patients denied consent for urodynamic study. Results: Preoperatively urodynamic SUI (n=6), detrusor instability (n=5), impaired bladder compliance (n=16) and voiding dysfunction (n=22) were noted. In the postoperative period too urodynamic SUI (n=l), detrusor instability (n=2), impaired bladder compliance (n=4), voiding dysfunction of hypotonic detrusor type(n=2) and obstructive voiding(n=2) were seen. The comparison of various urodynamic diagnoses between type I and type II fistulas preoperatively and postoperaively revealed a significant difference only in urodynamic SUI preoperatively (p=0.0118). Postoperatively five patients had a cystometric capacity less than 200 ml. The difference between various patient, fistula and treatment related factors in patients with and without urodynamic abnormalities was not statistically significant. Conclusions: Our study suggests that voiding abnormalities are quite common at short term follow up in patients with WF but whether they persist in long term needs to be seen. Also the findings in pre-operative urodynamic study did not always correlate with those in post-operative period. [ABSTRACT FROM AUTHOR]