Objective: To determine the knowledge, attitude and practice involved in the decision making on prophylactic oophorectomy among women awaiting hysterectomy for a benign disease. Methods: Pre-menopausal women scheduled for hysterectomy in a tertiary government hospital were interviewed regarding their views on prophylactic oophorectomy, menopause and hormone replacement therapy. Results: Seventy percent of women consented to outright hysterectomy with bilateral salpingoophorectomy. Almost half (49%) of the women consenting to oophorectomy have no idea as to the benefits of retaining the ovaries after a hysterectomy. Some women (14%) talked about the long term outcome of oophorectomy such as prevention of ovarian cancer but no women mentioned osteoporosis, breast or cardiac disease and dementia. Others (19%) expressed the fear of having another disease on the ovaries if it will be left behind. Majority of women had no idea about menopause and hormone replacement therapy. Sixty percent of the women left the major influence in making the decision to undergo hystertomy alone or oophorectomy with hysterectomy to their physicians. Conclusion: Most these women are under-informed regarding the benefits the benefits or disadvantages of retaining or removing the ovaries, menopause and hormone replacement therapy. It has become a routine practice to recommend oophorectomy based on age alone. Women who consented to outright oophorectomy relied on the decision of their physicians to proceed with the surgery. In this day and age, patients are far less empowered with information that will make them assume the role of a primary decision maker.
Human ; Female ; Middle Aged ; Adult ; OVARIECTOMY ; MENOPAUSE ; HORMONE REPLACEMENT THERAPY

OBJECTIVE: This study aimed to identify the predictors for treatment failure of medical management among admitted female patients diagnosed with pelvic inflammatory disease with tubo-ovarian abscess. METHODS: This was a retrospective nested case-control study, using chart review of all cases of pelvic inflammatory disease with tubo-ovarian abscess/complex (N = 49) admitted at the Department of Obstetrics and Gynecology, Philippine General Hospital from January 1, 2014 to December 31, 2018. RESULTS: Medical treatment failure was observed to be significantly higher (51.9%) among patients 40 years old and above as compared to patients less than 40 years old (13.6%). The risk of patients ≥40 years for failed management was 14x higher than those <40 years old (OR=14.00; 95% CI=1.06 to 185.5;p=0.04). The failed management group has significantly higher TOA size of 7.8 (7.8 ± 1.6) as compared to only 5.8 (5.8 ± 1.4) for medical treatment alone group. Correspondingly, those who failed have a significantly bigger volume of 120.4 ml (120.4 ± 84.5) as compared to only 55.2 ml (55.2 ± 40.6) for medical treatment alone group. Other predictive factors such as parity, admitting White blood cell count(WBC), C-Reactive Protein (CRP), and neutrophil-lymphocytic ratio(NLR) were all not significant. CONCLUSION: Tubo-ovarian abscess size of more than or equal to 7 cm, or a volume of more than or equal to 120 ml and advanced age of >40 were all predictive of failed response to medical treatment. Early recognition and intervention whether surgery or drainage may be beneficial to reduce morbidity and long-term sequelae of PID.
C-Reactive Protein ; Pelvic Inflammatory Disease ; Abscess ; Neutrophils ; Oophoritis ; Salpingitis ; Abdominal Abscess ; Lymphocytes