Ambiguous genitalia is a matter of concern and needs thorough evaluation and treatment. Gonadectomy becomes a potentially lifesaving procedure in patients with partial androgen insensitivity due to the increased risk of malignancy if left undiagnosed.We present a case report of two patients in their late 20s and 30s, raised as girls, who came with complaints of primary amenorrhea with ambiguous genitalia. Both patients had features of masculinization. Her MRI revealed an absent uterus, cervix, upper 2/3 of the vagina, and ovaries, with the presence of bilateral testicles. She was diagnosed with partial androgen insensitivity syndrome. The first patient underwent bilateral gonadectomy with hernia repair and nerve-sparing reduction clitoroplasty with labioplasty. She is under close follow-up with a further plan for augmentation mammoplasty. The second patient, however, refused clitoroplasty and underwent bilateral gonadectomy.Androgen insensitivity syndrome is an X-linked inheritance with a mutation in the AR gene. It consists of a spectrum of conditions ranging from complete insensitivity to less insensitivity towards testosterone, which results in a complete, partial, and mild form of androgen insensitivity syndrome. Studies have been done on cosmetic outcomes after genitoplasty in children with genital atypicalities, which showed significant improvement (p<0.001) and no difference in ratings by parents and surgeons.Surgeries done on patients with partial androgen insensitivity syndrome are not only lifesaving procedures, but with reasonable reassurance, these aesthetic surgeries help people live a life that otherwise would have been genetically compromised.

BackgroundThis study aimed to examine the role of a levonorgestrel intrauterine system (LNG-IUS) in the treatment of heavy menstrual bleeding (HMB) regarding improvements in bleeding patterns and quality of life (QOL) and determine the reason for its failure or withdrawal from treatment in some patients. MethodologyThis retrospective study was conducted in a tertiary care center in eastern India. A seven-year assessment, with both qualitative and quantitative assessments, of the effect of LNG-IUS in women with HMB was performed using the Menorrhagia Multiattribute Scale (MMAS) and Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36) score as a tool to assess the QOL, and the pictorial bleeding assessment chart (PBAC) to assess bleeding patterns. The study population was divided into the following four groups based on duration: three months to one year, one to two years, two to three years, and more than years. The continuation, expulsion, and hysterectomy rates were evaluated. Results

Objectives: Laparoscopic skills are not an innate behavior, nor can they be easily mimicked, and can only be acquired through hands-on training. The need for reliable training and its assessment is becoming increasingly important with the course of time. Materials and Methods: A retrospective comparative study was done in a tertiary care center where all patients undergoing hysterectomy by laparoscopic and abdominal route were included in the study. Objectives: Our study aims to compare the operative and postoperative complications of laparoscopic hysterectomy with abdominal hysterectomy. The study was conducted from June 2016 to October 2022. Results: The mean operative time for uteri size lesser than 12 weeks was found significant in the total laparoscopic hysterectomy (TLH) group (75 ± 25 min) to total abdominal hysterectomy (TAH) (117 ± 28 min, P < 0.001). The mean blood loss in the TLH group was significant (110 ± 30 ml vs. 160 ± 116 ml, P < 0.002). The mean hospital stay was significantly shorter in TLH (4 ± 2.4 days vs. 7 ± 2.41 days, P < 0.002). The operative and postoperative complications observed were 3.1% in the TLH group and 11.7% in the TAH group. Conclusion: TLH when performed efficiently has proved to be a preferable route over other conventional hysterectomies.