BACKGROUND Chronic pain is a common gynaecological problem. The causes of CPP are numerous like gynaecological causes or nongynaecological causes, but CPP is very difficult to diagnose. So, aim of the study is to evaluate the use of TVS based on hard and soft markers in detection of pelvic pathology in women with chronic pelvic pain and compare it with laparoscopy for knowing sensitivity and specificity. MATERIALS AND METHODS Study was hospital based. Total number of women taken were 220, who were attending regular outdoor in Mahatma Gandhi Medical College and Hospital, Jaipur with history of Chronic Pelvic Pain (CPP). Age group was 18-50 years. RESULTS This study was carried out in Mahatma Gandhi Medical College and Hospital, Jaipur during October 2010 to October 2012. There was a statistically significant association between TVS based hard markers and laparoscopic findings. Out of 120 cases of abnormal scan of TVS 116 were abnormal on laparoscopy, thereby showing PPV of 93.55%. TVS based hard markers had higher Specificity (73.33%) and Sensitivity (61.05%). CONCLUSION Though laparoscopy is the gold standard for diagnosis of chronic pelvic pain, it is concluded that TVS with use of hard and soft tissue markers is very useful in diagnosis of Chronic Pelvic Pain.
I n 1786, John Hunter was the first to observe that the testis was located in the abdomen of the fetus. Undescended testis (UDT) is a common congenital problem encountered in pediatric age group. Cryptorchid testis, literally meaning hidden or obscure testis, refers to the absence of testis in the scrotal position and is most commonly undescended or maldescended. Overall, up to 4% of full-term male newborns may present with UDT. The prevalence is around 33% in premature male newborns and it reaches 60-70% if the birth weight is <1500 g [1]. In majority, the testis descends within the subsequent 3 months, resulting in an incidence of 1% UDT at 1 year. The testis is unlikely to descend after this time. However, testicular descent after 3 months of age is also possible; especially, in preterm infants [4]. About 10% of the cases are bilateral and are commonly associated with complex syndromes or other congenital malformations such as abdominal wall defects or neural tube defects [2].Factors that predispose to UDT include prematurity, low birth weight, small for gestational age, twins, genetic predisposition, endocrine disorders (e.g. disruption of hypothalamic-pituitarygonadal axis), and environmental factors such as nicotine, alcohol, pesticides, and maternal exposure to estrogen during the first trimester [2]. Since 80-90% of a testis is composed of seminiferous tubules, the volume of the testis is significantly related to the semen profile and testicular function, hence testicular volume is an indicator of development of the testis [3]. Since boys with UDT may have an increased incidence of testicular hypoplasia, atrophy, infertility, torsion of testis, trauma, and testicular malignancy, there is a need for locating testis and placement in the scrotum at an early age.Principles of surgical management of palpable UDT are well established. Management of non-palpable testis is challenging and laparoscopy is an ideal tool for diagnosis and management in this scenario. There is a need for spreading the awareness regarding current concepts of management of UDT; especially, among pediatricians, general surgeons, and referral doctors. Children who undergo early orchiopexy need to be followed up, to evaluate outcomes of UDT with respect to growth potential [4].
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