1.Androgen insensitivity syndrome (AIS).
Iskandar Diana ; Alensuela Anna Belen I.
Philippine Journal of Obstetrics and Gynecology 2016;40(2):39-46
Androgen Insensitivity Syndrome (AIS) is a rare condition, it is an X-linked-mutation that is considered as a disease caused by resistance of androgen receptor to its actions. It is expressed in a variety of phenotypes ranging from male infertility to completely normal female external genitalia. This is a case of a 25 year-old with Complete Androgen Insensitivity Syndrome (CAIS), presented as phenotypical female with secondary sexual development, bilateral inguinal masses. Gonadectomy, estrogen replacement therapy and psychological support are part of long term management.
Human ; Female ; Adult ; Androgen-insensitivity Syndrome ; Ar Protein, Human ; Receptors, Androgen ; Estrogen Replacement Therapy ; Phenotype ; Infertility, Male ; Mutation ; Genes, X-linked ; Sexual Development ; Genitalia
2.Sealed off: A case of complete cervical and vaginal agenesis.
Halim William ; Alensuela Anna Belen I.
Philippine Journal of Obstetrics and Gynecology 2015;39(3):22-27
A case of 17 year-old nulligravid who initially presented with a 3 year history of cyclic hypogastric pain with gradual abdominal enlargement. She was assessed with Imperforate Hymen and underwent hymenectomy and ultrasound-guided aspiration of blood clots per vagina. No vaginal canal was noted. Patient was subsequently lost to follow up.
Patient returned due to recurrence of hypogastric pain and enlargement of abdomen. Transrectal ultrasound revealed hematocolpos with hematometra. Assessment was Cervical and Vaginal Agenesis. Patient underwent exploratory laparotomy, total abdominal hysterectomy with bilateral salpingectomy.
According to American Fertility Society, there is no classification for a complex mullerian malformation such as mixed vaginal and cervical Agenesis. There is no reported case of mixed vaginal and cervical agenesis in the Philippines.
The best surgical management is still controversial. Conservative surgical method should be considered. A rare case of mixed vaginal and cervical agenesis is being presented where the management is a dilemma.
Human ; Female ; Adolescent ; Cervix Uteri-abnormalities ; Vagina-abnormalities
3.Herlyn Werner Wunderlich syndrome: A report of two cases.
Morante Catherine Mae Munoz ; Alensuela Anna Belen I.
Philippine Journal of Obstetrics and Gynecology 2015;39(2):33-38
The association of renal agenesis with ipsilateral blind hemivagina and uterus didelphys is reported as Herlyn-Werner-Wundelich (HWW) syndrome. Presented herein are two cases of HWW syndrome, each with different set of clinical presentations but both with the same arranged diagnostic method and management executed. The first case, 15 year-old nulligravid, manifested severe dysmenorrhea since menarche and is worsening over the past months. On the other hand, the second case, 29 year-old Gravida 1 Para 0 (0010), exhibited cyclic hypogastric pain and gradually enlarging right pelvic mass. Both cases underwent computed tomography scan and ultrasound examination which revealed uterine didelphys, hemivagina obstruction and ipsilateral renal agenesis, yet each has different laterality of mullerian anomaly. Together were managed with full resection of the vaginal septum as well as drainage of the hematometrocolpos, which are, today, the main treatment for patients with HWW syndrome
Human ; Female ; Adult ; Adolescent ; Genitalia
4.Practice of minimally invasive gynecologic surgery in the Philippines during the COVID-19 Pandemic
Maria Antonia E. Habana ; Prudence V. Aquino-Aquino ; Jennifer A. Aranzamendez ; Marinella Agnes G. Abat ; Anna Belen I. Alensuela ; Jean S. Go-Du ; Ma. Asuncion A. Fernandez ; Joan Tan-Garcia ; Gladys G. Tanangonan ; Anne Marie C. Trinidad ; Chiaoling Sua-Lao
Philippine Journal of Obstetrics and Gynecology 2021;45(3):111-116
Objective:
This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic.
Materials and Methods:
MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care.
Results:
A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE.
Conclusion
The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.
COVID-19
;
Personal Protective Equipment
;
Telemedicine