Background: Abnormal uterine bleeding (AUB) of ovulatory disorders is defined as the state of abnormal bleeding from the genital tract without any clinically detectable organic, systemic and iatrogenic cause. AUB is one of the common gynaecological issues among the patients visiting the hospital as it could affect at least 1/3rd of women in the child bearing age. Ormeloxifene, a nonsteroidal, nonhormonal and selective estrogen receptor modulator is a highly safe drug in treating acute and abnormal menstrual bleeding. Methods: The 40 cases of heavy menstrual bleeding (HMB) with ovulatory disorder in the range of 40-52 years of age were treated with 60 mg ormeloxifene twice a week for first 12 weeks and once a week for next 12 weeks. The patients were evaluated for haemoglobin, pictorial blood loss assessment chart (PBAC) score and endometrial thickness before and after treatment.Results: A significant decrease in endometrial thickness and PBAC score was observed. Also, the level of haemoglobin is found to increase significantly from 8.4±0.8 to 9.9±0.7. In this study, following 6 months of treatment with ormeloxifene, 90% of cases had marked improvement in their symptoms, while 10% of the patients required surgical management i.e., hysterectomy. Amenorrhea was observed in 7.5% of total cases and hypomenorrhea in 5% cases.Conclusions: Based on these results we could conclude that ormeloxifene could be the drug of choice in patients with AUB as it is very safe with manageable side effects. This simple drug-based therapy has facilitated compliance, tolerability and noticeable reduction of symptoms resulting in satisfaction towards the treatment.
Background: Pelvic organ prolapse is a descent of the pelvic organs into the vagina, frequently associated with local pelvic symptoms. Pelvic floor support is essential to maintain the normal anatomy. Recent studies of genital prolapse suggests that it is more important to improve the patient satisfaction and reduce complication than to achieve anatomical success. The purpose of the audit of genital prolapse management in this retrospective study is to know and understand the decision making, selection of patients for a particular surgery and to know and avoid the complications of genital prolapse management.Methods: This retrospective descriptive study was conducted at SVMCH and RC during the period of January 2020 to December 2021. The detailed analysis of the cases, symptomatology, surgical methods, complications and follow up were studied.Results: We managed 110 cases of genital prolapse. 35 patients had massive/ huge genital prolapse (POP Q Stage 4). 75.4%were found in the age group beyond 55 years, 66.3% were multiparous. 31% of the patients came with massive prolapse (POP Q-stage IV), 5% showed cervical elongation ,7% showed vault prolapse, Majority of our patients (63%) were managed by vaginal hysterectomy with pelvic floor repair. Followed by pessary, Fothergill’s surgery, Purandare’s surgery, Le forte’s, sacrospinal fixation, hysterosacropexy, pessary with thiersch stitch.Conclusions: The choice of management of genital prolapse has to be tailored according to the patients needs and pathology. The younger trainees have to be trained to get the skills of various surgeries of genital prolapse.
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