Introduction 

During my long career in medicine which span for 37 years, I witnessed many changes in the profession, some were very good others were not. Many techniques which changed the face of the profession came into being while others came in and faded away without leaving a trace. Furthermore, many outdated practices resisted the wind of change, and persisted despite their ineffectiveness and potential harm. Despite the great forward leaps in gynaecological training, certain areas are not yet well covered. Chronic pelvic pain, for example, is not addressed by any structured training, and usually a multidisciplinary approach to consider nongynaecological causes does not exist, or at best fractured and inefficient. Similarly, in many parts of the world abnormal uterine bleeding is considered to be a simple gynaecological problem delegated to the most junior, and investigated with D&C at this age of sonohysterography. It is often treated empirically with progestogens first, and with a hysterectomy in many cases for ‘failed medical treatment’ at this age of the mirena system and second generation endo-metrial ablation techniques. The intricate nature of these two problems is beyond everyday basic training within a general outpatient gynaecology clinic. A multidisciplinary chronic pelvic pain assessment unit, and an imaging oriented abnormal uterine bleeding service are best suited for that purpose. It is not unusual for many patients to present with the two problems at the same time, and they could well be two manifestations of the same pathology. Accordingly, the trainer himself or herself should be aware of the broader aspects of these issues and the current thinking regarding the use of minimally invasive office diagnostic and therapeutic procedures. Dexterity in transvaginal ultrasound scan examination would extend the scope of clinical judgement, as the probe should be the eye in the pelvis for all gynaecologists. Operative hysteroscopy, on the other hand, should not be the domain of a privileged few, and saline infusion sonohysterography should be available to all patients with abnormal uterine bleeding. With all this in mind, I felt there is a gap in the medical library for a new gynaecological text to be simple and logical, but at the same time de-tailed and well illustrated. A new approach is needed to address chronic pelvic pain and abnormal uterine bleeding which are the two main gy-naecological problems in the primary care and hospital gynaecology outpatient departments. Continuous learning and interaction with new ideas and information should be a target for all professionals irrespective of their age or experience. However, a time might come when one feels obliged to share with others the experience, knowledge and thoughts accumulated over the years. I felt I have reached that stage and I hope this book would be a useful contribution to help younger colleagues to reflect on the two topics which I covered in some detail. I have also included a long list of relevant references in each chapter for those who have special interest in the subject, and would like to have further core information. I also used many pictures to give a pictorial concept to these two difficult and complex subjects. This is especially so for doctors who are not actively involved in scanning their own patients, and not regularly involved in endoscopic surgery. The learning curves for both disciplines could be steep, but like all other techniques, they could be mastered with training and perseverance. I could see a day when no gynaecologist would be able to practise office gynaecology, which is the platform for one stop clinics, without being dextrous in both disciplines. This is particularly so, when dealing with patients presenting with abnormal uterine bleeding.