DC Dutta's Textbook of Gynecology

607 Pages·2020·31.293 MB·English

by  Hiralal Konar

DC Dutta’s
Textbook of
Gynecology
including Contraception
ONLINE VIDEO CONTENT LIST
YYTotal Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy
YYVaginal Hysterectomy
YYDiagnostic Laparoscopy with Chromopertubation
YYLaparoscopic Ovarian Cystectomy
OTHER BOOKS BY THE SAME AUTHOR
YYTextbook of Obstetrics
YYBedside Clinics & Viva-Voce in Obstetrics and Gynecology
YYManual of Obstetrics and Gynecology for the Postgraduates
YYA Guide to Clinical Obstetrics and Gynecology
YYEmergencies in Manipulative and Operative Obstetrics
DC Dutta’s
Textbook of
Gynecology
including Contraception
Eighth Edition
DC Dutta MBBS DGO MO (Cal)
Professor and Head, Department of Obstetrics and Gynecology
Nilratan Sircar Medical College and Hospital, Kolkata, India
Edited by
Hiralal Konar (Hons; Gold Medalist)
MBBS (Cal) MD (PGI) DNB (India)
MNAMS FACS (USA) FRCOG (London)
FOGSI Representative to Asia Oceania Federation of Obstetricians and Gynecologists (AOFOG)
Member, Oncology Committee of AOFOG
Professor and Head, Department of Obstetrics and Gynecology
Agartala Govt. Medical College and G B Pant Hospital, Tripura, India
Chairman, Indian College of Obstetricians and Gynecologists (2013)
Formerly Professor, Department of Obstetrics and Gynecology
Calcutta National Medical College and Hospital, Kolkata
One-time Professor and Head, Department of Obstetrics and Gynecology
Midnapore Medical College and Hospital, West Bengal University of Health Sciences, Kolkata, India
Rotation Registrar in Obstetrics, Gynecology and Oncology
Northern and Yorkshire Region, Newcastle-upon-Tyne, UK
Examiner-National: MBBS, DGO, MD and PhD of different Indian Universities
and National Board of Examination, New Delhi, India
International: Royal College of Obstetricians and Gynaecologists, (MRCOG), London,
Royal College of Physicians of Ireland (MRCPI)
Recipient, “Pride of FOGSI” award – 2019, for exemplary efforts toward upliftment of Women’s Health in India
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© Copyright reserved by Mrs Madhusri Konar
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information
about the subject matter in question. However, readers are advised to check the most current information available on
procedures included and check information from the manufacturer of each product to be administered, to verify the
recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the
responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s)
assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this
book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information
about the subject matter in question. However, readers are advised to check the most current information available
on procedures included and check information from the manufacturer of each product to be administered, to verify
the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is
the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/
editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of
material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If
such advice or services are required, the services of a competent medical professional should be sought.
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DC Dutta’s Textbook of Gynecology
Seventh Edition: 2016
Eighth Edition: 2020
ISBN: 978-93-89587-88-3
Dedicated to
The students of gynecology—
past and present

Preface to the Eighth Edition
Dutta’s Textbook of Gynecology has stepped in its 8th edition through its journey over the last 31 years. Its first
edition was in photo-type setting in 1989 with 450 pages. Concept was to provide students with the knowledge of “Medical
Gynecology” as maternity care was the need of those days. The contribution of this great teacher to the medical fraternity
was monumental. This provided a huge impetus to the successors to follow his footsteps. Significant development has
been observed in each edition of this book concurrent to the progress of science, technology and imaging. This textbook
has now been considered the classic in the field both nationally and internationally. The advances observed in all the areas
of subspeciality like: reproductive endocrinology, infertility, urogynecology, oncology, endoscopy and general gynecology
are adequately reflected in this edition. Consistency and uniformity with updated information in all the chapters are the
special features of this book.
Dutta’s Gynecology is comprehensive and user friendly with its easy-to-read format. The presentation of this book with
its quality of graphics, design, profuse illustrations (366), high quality photographs (330) and imaging studies are the
special attraction. Numerous tables, boxes, flowcharts, and algorithms are there, for ease of study and reproducibility. The
key points are at the end of each chapter to provide an outline synopsis of the entire chapter. This is of value for quick and
easy revision. The state-of-the-art in the book lies in the presentation which is simple, lucid, clear and concise. Above
all, it provides a balanced distillation of evidence-based information upon which a student, trainee resident, a practitioner
and a nurse can fully depend.
All the chapters have been exhaustively revised, updated and many of these thoroughly rewritten. Practical gynecology
(Chapter 38), contains a total of 107 high quality photographs and plates of imaging studies. Few hundreds of viva
questions along with answers and explanations are presented to enable the students to face the clinical and viva voce
part of examination. The total information given in Chapter 38 amounts to a “mini-textbook-cum color atlas” of
gynecology.
Considering the vast amount of scientific information and the research, it is practically impossible to limit the subject
matter within the few pages of the book. Arrangements have been made through electronic media for the readers who wish
to know more. Information regarding the examination situation (theory, viva voce, multiple choice questions and answers,
operation video clips) have been provided through the electronic resources (www.dcdutta.com/www.hiralalkonar.com).
My aim in this book has always been to help the students, residents and clinicians to remain updated with the
knowledge that has passed the test of clinical relevance. I do hope this comprehensive textbook will continue to be
an immense educational source to readers as ever. The readers will enjoy this edition and learn as much as they can in this
ever-evolving field, in order to provide a quality care to women.
According to the author’s desire, the book is therefore dedicated once again “to the students of gynecology: past and
present”.
Hiralal Konar
[email protected]
P–13, New CIT Road
Kolkata–700014

Preface to the First Edition
Since my publication of Textbook of Obstetrics about 5 years back, I have been pressed hard by my esteemed colleagues
and the students all over the country and abroad to write a Textbook on Gynecology of similar style to fill up the deficit.
Initially, I was hesitant to proceed with the stupendous task but considering the fact that a compact, comprehensive and
practical-oriented fundamental book in gynecology is not available to the undergraduates, I have decided to comply with
their request.
The book has been written in a lucid language in author’s own style. Extensive diagrams, photographs, and flowcharts
(schemes) have been depicted throughout the text to give clarity of the subject. Due attention has been paid to project
the fundamental principles and practice of gynecology. As such, more emphasis has been given on medical gynecology.
But for that, indications, limitations, and principles of techniques of operations have received adequate consideration.
The book is thus made invaluable not only to the medical students but also the practising physicians and students of
nursing.
The author wishes to acknowledge gratitude to his esteemed colleague Dr N Chowdhury, MBBS, DGO, MO (Cal), for
his contribution to the topic “Hormone Therapy in Gynecological practice”. Dr Santosh Kr Paul, MBBS, DGO, MO(Cal), Prof,
Dept of Obst and Gyne, NRS Medical College, Calcutta, deserves full appreciation for his contribution in a lucid way to the
topic “Radiotherapy and Chemotherapy in Gynecology”. The author has much pleasure in expressing grateful thanks to
Dr BN Chakravorty, MBBS, DGO, MO (Cal), FRCOG (Eng), and Dr KM Gun, MBBS, DGO, MO (Cal), FRCOG (Eng), FRCS (Edin),
FACS (USA), for their valued suggestions as and when required and their contribution of photographs to enrich the text.
I gratefully record my thanks to Dr Subir Kumar Dutta, MBBS, DCP, MD (Path & Bact), Prof, Dept of Pathology and
Bacteriology, University College of Medicine, Calcutta, for the microphotographs depicted throughout the text. The author
records his thanks to Dr SM Dali Prof, Obst and Gyne; Dr Bhola Rijal, Associate Prof, Obst and Gyne of Teaching Hospital, and
Dr (Mrs) Dibya S Malia, Director, Maternity Hospital, Kathmandu, Nepal, for their contribution of few outstanding
photographs to enrich the text.
The author expresses much pleasure all the time to the House Surgeons, Internees and students of Nilratan
Sircar Medical College, Calcutta, for the help they have rendered in preparation of the final drafts of the manuscripts, check
up of the proofs and compiling the index. Their help is invaluable and unforgettable and without which the book could
never have been published.
The author wishes to thank Mr Biren Das for his exhaustive number of drawings and flowcharts which enrich the lucidity
of the book. The author also thanks Mr Ranjit Sen for preparation of photographs (black and white) depicted throughout
the text. The author has much pleasure in expressing his appreciation to Mr Bimal Bhattacharya, MSc, LLB (Cal), DSW, DHE,
Lecturer, Health Education and Family Welfare, Postpartum Unit, NRS Medical College, Calcutta for the patience shown in
dealing with correction of manuscripts and proofs.
In preparing the textbook, the author has utilized the knowledge of number of stalwarts in his profession and consulted
many books and publications. The author wishes to express his appreciation and gratitude to all of them including the
related authors and publishers.
The author still confesses that as a teacher, he has learnt a lot from the students and more so while writing this book and
as such he could not think to dedicate the book to anyone else than the students of gynecology—past and present.
DC Dutta