What is your opinion of doing bilateral salpingo Oophorectomy at the time of hysterectomy. Coz patients are of the opinion that if they undergo Tubectomy,they will land with a BIGGER operation that is hysterectomy.therefore some people come asking to do a hysterectomy after child bearing. If only hysterectomy is done when indicated and later if they require laparotomy for ovarian cyst /tumour,patients question "why you didn't remove these appendages earlier. One patient had hysterectomy,followed by laparotomy again for an ovarian cyst,later another cyst on other side -third surgery .she again developed cystic mass in the pelvis for which she had fourth surgery . Though we leave ovaries ,their function gradually comes down after hysterectomy and they have PMS and osteoporosis. When I have to do a hysterectomy ,I remove the appendages if she is above 40 years and retain them if she is young. What are your opinions

48 yr female with bleeding PV since a month.. usg suggested fibroid.. grossly uterus was bulky with myometrium showing trabeculations and blood filled cysts.. please comment on histopathology of uterus and cervix

42 yr old female came with lower abdominal pain since 3 months... more during night time also complains of burning micturation since 7 days. o/e GC mod Afeb. vitals stable *on P/V vulva vagina NAD cervix closed tender uterus anteverted bulky.8 week size. mobility decreased Adnexal masses felt POD - NAD *Menstrual h/o - menarche 15 . cycles irregular - 35 - 45 days lasts for 4 days.. pain aggravates during menstruation normal flow * USG Done s/o uterus with adenomyosis with 2 Fibrods evidence of cervicitis Rt ovary 2 cysts Kindly suggest further management ....?????

TAH specimen... 1&3 sections from the cervix, 2,4,5&6 from the uterine mass

21 yr old unmarried girl c/o white discharge p/v and irregular cycles since last 18 months. she is taking treatment on and off from gynecologist and GP but her symptoms is not going away. usg report is attached. what should be the management of the case ?