Background: Purandare described a technique for the surgical treatment of genital prolapse in young women in 1965. This technique of cervicopexy is easy to perform and provides dynamic support to the uterus. The objective of study is to evaluate the role of modified Purandare's cervicopexy in the treatment of genital prolapse in reproductive age group and to study the pregnancy outcome and fertility in patients who have undergone modified Purandare's sling surgery. Methods: Between January 2007 and December 2015, 20 women in the reproductive age (mean age 30.5 years, range 24 to 37 years) underwent modified Purandare's cervicopexy at Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India. Of these, 2 (10%) patients were nulligravida, 7 (35%) were primipara and 11 (55%) were multigravida. Four (20%) women had associated infertility. Additional surgeries like tubectomy were performed in 4 (20%) women, tubal patency test in 3 (15%), ovarian drilling in 2 (10%) and myomectomy in 2 (22.2%) women, and cystocele repair was done in 4 women (20%). Results: All 20 patients were analysed for intraoperative and postoperative complications. All were followed up for mean duration of 12 months. There were no reported intra or post-operative complications. Out of 4 infertile women, 2 conceived spontaneously 6 months after the surgery. Of these, one delivered successfully at term by lower segment caesarean section and other by normal vaginal delivery. One woman conceived 8 months after the surgery spontaneously, antenatally followed for 3 months and then later was lost to follow-up. There was no recurrence of prolapse. Conclusions: Nulliparous prolapse can be treated by various surgical procedures, each having their own merits and de-merits. Our modification of Purandare's cervicopexy is simple, effective and is less technically demanding.

Background: Cervical cancer is the second leading cause of death in india. it is also one of the few malignancies where an infectious etiological agent human papilloma virus (HPV) has been identified. With the advent of HPV vaccination, it is possible to reduce the morbidity and mortality associated with carcinoma cervix. But biggest hurdle to achieve this is the lack of awareness about the availability and use of HPV vaccine. This study was conducted to know knowledge and awareness of HPV infection and vaccination among medical and paramedical students. We also evaluated the acceptability and coverage of HPV vaccine among these students.Methods: This study was conducted among a total of 520 female students of the Sri Dharmasthala Manjunatheshwara University with the help of a questionnaire. The study group included 207 MBBS students, 167 BDS students, 89 nursing students and 57 physiotherapy students.Results: Most of the students were in 18-20 years’ age group. Nearly 40.57% of the students knew that HPV is sexually transmitted and 29.80% were aware that this infection can be prevented. Availability of HPV vaccine was known to 75% of the students and the main source of their information was through their college teachings. Nearly 43.75% of the students knew HPV vaccine protects against cervical cancer and 26.73% of the students were vaccinated. Overall knowledge and awareness were better among medical students.Conclusions: A lot of work needs to be done so as to make the target population accept HPV vaccine. There is a great difference between awareness of availability of the vaccine and its use. This emphasizes the need for health care professionals to take special interest in promoting this vaccine in the general population.

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.

INTRODUCTIONHysterectomy is a commonly performed gynecological procedure.1 Nondescent vaginal hysterectomy (NDVH) is removal of uterus through vagina in absence of descent. Vaginal route is preferred for removing uteri, as it is natural route, scarless, gives safer and better results than abdominal route.2 Because of increased cesarean sections, women undergoing hysterectomies with cesarean sections are increasing.3 Earlier previous cesarean section was relative contraindication to vaginal hysterectomy due to uterovesical adhesions and risk for unintended cystostomy. [4][5] Skill, experience of surgeon is important in determining the route. This study will help in assessing safety, feasibility of NDVH in women with previous one, two and three cesarean section in absence of uterine prolapse. ABSTRACTBackground: Non-Descent Vaginal Hysterectomy (NDVH) is removal of uterus through vagina in non-prolapsed uterus. Objective of present study was to assess safety, feasibility of NDVH in patients with previous cesarean section. Methods: Retrospective study was conducted in department of Obstetrics and Gynecology of Shree Dharmasthala Manjunatheshwara (SDM) College of Medical Sciences, Dharwad, India from April 2008 to June 2016. Effort was made to perform hysterectomies vaginally in women with benign conditions with history of one, two or three caesarean sections. Information regarding age, parity, number of previous LSCS, uterine size, blood loss, duration of operation, difficulties in separating bladder, intra -operative, post-operative complications were recorded. Results: Total thirty cases were selected for NDVH with history of one, two and three cesarean sections. All successfully underwent NDVH, except one in which bladder injury occurred which was repaired at same time vaginally. Thirteen patients had previous one Lower Segment Cesarean Section (LSCS), sixteen had two LSCS and one had three LSCS. Commonest indication was abnormal uterine bleeding followed by leiomyoma of uterus. Mean duration of surgery was 97 min. Mean blood loss was 150 ml. Post-operative complications were minimal. Patient mobility, resumption of daily activities was fast. Mean hospital stay was 4-5 days. Conclusions: Vaginal hysterectomy is safe, cost effective method of hysterectomy in women with previous cesarean section scar requiring hysterectomy for benign conditions with fewer complications, shorter hospital stay and less morbidity.

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