1.Adenomyosis in Mayer-Rokitansky-Kuster-Hauser Syndrome
Laurice Gizelle C. Ramos ; Maria Lilia T. Reyes ; Debby F. Pacquing-Songco
Philippine Journal of Obstetrics and Gynecology 2019;43(6):22-26
Mayer-Rokitansky-Kuster-Hauser syndrome, the second most common cause of primary amenorrhea, is a congenital anomaly caused by defective Mullerian duct development. It is the absence of uterus, cervix and upper two thirds of the vagina that results in primary amenorrhea. This is a case of a 42-year-old, nulligravid with primary amenorrhea complaining of acute abdominal pain. She has no co-morbidities or previous surgeries. Examination revealed an absent cervix and a left adnexal mass. Ultrasonography revealed an atrophic uterus with no endometrial stripe and cervix, with possible ovarian tumor versus myoma. Impression was mullerian agenesis with pelvoabdominal mass in torsion. She then underwent total abdominal hysterectomy with bilateral salpingectomy and adhesiolysis. Intraoperatively, there were two hemiuteri connected by a fibromuscular stalk. Left hemiuterus was dextrorotated, adherent to the sigmoid mesentery and peritoneum. Histopathology confirmed absence of endometrial cavity but with adenomyosis in bilateral uterine buds. Chromosomal analysis confirmed 46, XX karyotype.
Adenomyosis
2.Tumor rupture and partial gut obstruction: Atypical presentations in a patient with adenomyosis
Ma. Patricia Grace O. Siao ; Izabelle Julienne A. Figueras‑Prieto
Philippine Journal of Obstetrics and Gynecology 2023;47(4):220-228
A 49-year-old woman, Gravida 8 Para 8 (8007), came in due to vomiting and enlarging abdominal mass. Initial diagnosis was partial gut obstruction and acute kidney injury probably secondary to adenomyosis versus colonic pathology. Ultrasound showed adenomyosis but computed tomography scan showed a uterine mass with possible tumor rupture and mass effects. Emergency hysterectomy was done and showed an ill-defined endometrial mass with multiple areas of rupture. It was diagnosed with malignant but final histopathology revealed extensive adenomyosis with acute inflammation and necrosis with no malignancy identified. Unusual symptoms such as uterine rupture and mass effects can accompany adenomyosis, alongside typical signs like pain and bleeding. Ultrasound aided the diagnosis, although it missed uterine rupture, highlighting its limitations. Magnetic resonance imaging could have been useful. Ultimately, histopathology is the gold standard for diagnosing adenomyosis.
Adenomyosis
;
Necrosis
3.Prevalence of abnormal uterine bleeding according to the International Federation of Gynecology and Obstetrics Classification (PALM-COEIN) among reproductive-aged women admitted in a tertiary hospital in Las Piñas
Antonette B. Delas Alas ; Ina S. Irabon
Philippine Journal of Reproductive Endocrinology and Infertility 2023;20(2):66-71
Objective:
To determine the prevalence of the causes of abnormal uterine bleeding based on
the FIGO (PALM-COEIN) Classification, among patients admitted at a tertiary hospital in Las
Pinas City
Methods:
A cross sectional (retrospective) study was done. Patients aged 15-50 years old
who were admitted due to abnormal uterine bleeding from January 2017 to December 2019
were included. Patients with AUB due to pregnancy, vaginitis, bleeding before menarche, and
bleeding after menopause were excluded from the study. Patient’s data as to age, obstetrical
score, co-morbidity, bleeding patterns were tabulated.
Results:
A total of 455 subjects were included in the study. Results showed that the most common
causes of abnormal uterine bleeding among admitted patients in Perpetual Help Medical Center
Las Piñas from January 2017 – December 2019 were due to structural causes (91%). Most
prevalent was bleeding due to polyps (50.5%), followed by adenomyosis (18.8%), leiomyoma
(16.04%), and malignancy (6.2%). Prevalence of non-structural causes of bleeding was 0.4%
for coagulopathy, 3.3% due to ovulatory dysfunction, 4.6% due to endometrial dysfunction,
and 0.2% for AUB-N.
Conclusion
Based on this 3-year retrospective study, structural causes are the most common
causes of AUB, comprising about 91% of all patients admitted for AUB. The most common
structural causes are AUB-P (50.5%), followed by AUB-A, AUB-L and AUB-M. Prompt recognition
of the causes of AUB is very important, to prevent complications such as severe anemia and
shock. Proper treatment, be it surgical or medical, also depends on the exact cause of AUB.
Polyps
;
Adenomyosis
4.Clinical significance of CA125 antigen levels in patients with adenomyosis and leiomyomata uteri.
Sa Jin KIM ; Jong Chul SHIN ; Jang Heub KIM ; Do Kang KIM
Korean Journal of Obstetrics and Gynecology 1991;34(2):253-257
No abstract available.
Adenomyosis*
;
Humans
;
Uterus*
5.Clinical significance of CA125 antigen levels in patients with adenomyosis and leiomyomata uteri.
Sa Jin KIM ; Jong Chul SHIN ; Jang Heub KIM ; Do Kang KIM
Korean Journal of Obstetrics and Gynecology 1991;34(2):253-257
No abstract available.
Adenomyosis*
;
Humans
;
Uterus*
6.3 Cases of Primary Tubal Cancer Incidentally Diagnosed After Benign Gynecologic Operation.
Yeon Jung JUNG ; Kyung Suk CHI ; Jun Soo KIM ; Kyoung Won KIM ; Do Gyun KIM ; Hoe Saeng YANG ; Jae Chul SIM ; Tae Jung JANG ; Jee Young HWANG
Korean Journal of Obstetrics and Gynecology 2006;49(8):1779-1787
We experienced 3 cases of early stage tubal cancer incidentally recognized during the operation and diagnosed pathologically after surgery of the tubo-ovarian abscess, the symptomatic adenomyosis, the myoma with adnexal cyst patients, so we report our cases with a review of the literature.
Abscess
;
Adenomyosis
;
Humans
;
Myoma
7.The Distribution of CA-125 Level Among the Patients Who Underwent Hysterectomy.
Eun Seop SONG ; Jung Mook YOON ; In Hwa NOH ; Young Koo LIM ; Sung Ook HWANG ; Moon Whan IM ; Byoung Ick LEE ; Jong Hwa KIM
Korean Journal of Gynecologic Oncology and Colposcopy 2000;11(1):55-59
OBJECTIVES: To understand the importance of the serum level of Ca-125 among pelvic mass, we performed a study. METHOD: From January to December 1998, we performed the study. Before hysterectomy, we performed a blood sampling to know the serum level of Ca-125, After hysterectomy, we weighed the uterus and measured the thickness of endometrium and other histologic characteristics. RESULTS: We performed my research to 80 peoples. The relation between uterine weight and the serum level of Ca-125 is little, if ever(R2=0.0007), and the relation between the thickness of endometrium and the serum level of Ca-125 is also little, if ever(R2=0.0353). The relation between leiomyoma, the cycle of endometrium and the serum level of Ca-125 were also little, but there was a close relationship between adenomyosis and the serum level of Ca-125. CONCLUSION: There was little relationship between uterine weight and the serum level of Ca-125.
Adenomyosis
;
Endometrium
;
Female
;
Humans
;
Hysterectomy*
;
Leiomyoma
;
Uterus
8.A case of ovarian pregnancy with focal adenomyosis mimicking cornual pregnancy that managed by laparoscopy.
Hyun Jung CHO ; Jai Youn SONG ; Hyun Sung KWACK ; Ki Cheol KIL ; Gui Se Ra LEE ; Young Ok LEW ; Joo Hee YOON
Korean Journal of Obstetrics and Gynecology 2006;49(5):1149-1153
Ovarian pregnancy is rare form of ectopic pregnancy occurring in 0.5-1% of all ectopic pregnancies. But the presenting symptom is very similar and difficult to distinguish with other forms of ectopic pregnancy. We report a case of ovarian pregnancy mimicking cornual pregnancy managed with laparoscopy. Early detection is important role in preserving fertility to avoid the ablation of functional ovarian tissue. The diagnostic criteria, etiology, and management are discussed.
Adenomyosis*
;
Female
;
Fertility
;
Laparoscopy*
;
Pregnancy
;
Pregnancy*
;
Pregnancy, Ectopic*
9.Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) and Total Abdominal Hysterectomy (TAH).
Korean Journal of Obstetrics and Gynecology 2002;45(1):24-31
OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total abdominal hysterectomy (TAH). METHOD: 60 of LAVH cases and 60 of TAH cases, which were performed at Dankook university hospital from April 1998 to December 2000. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, weight of uterus, operation time, blood loss, hospital stay and complications. RESULTS: Total 120 of hysterectomy cases (60 LAVH, 60 TAH) were enrolled in this study. All operations, LAVH and TAH, were performed by same surgeon. There were no significant differences in patient's characteristics (age, height, weight, parity) between the two groups. The main preoperative indication was myoma uteri, followed by adenomyosis, CIN III, for both LAVH and TAH. The mean uterine weight of TAH cases was larger than LAVH (214.8+/-88.1 gm for LAVH, 377.1+/-269.0 gm for TAH, p<0.05) cases. The operation time was longer in LAVH operation (114.3+/-31.4 min for LAVH, 93.7+/-30.2 min for TAH, p<0.05). The blood loss was not significantly different between the two groups (185.5+/-53.3 ml for LAVH, 205.8+/-65.8 ml for TAH, p>0.05). The hospital stay of LAVH was significantly shorter than TAH (4.9+/-0.6day for LAVH, 7.5+/-1.9day for TAH, p<0.05). CONCLUSION: In the comparison of LAVH and TAH operation, we conclude that LAVH can be considered as the first choice when determining hysterectomy method, unless contraindication prevents it. LAVH has advantages of shorter hospitalization and the acceptable complication rate.
Adenomyosis
;
Female
;
Hospitalization
;
Hysterectomy*
;
Hysterectomy, Vaginal*
;
Length of Stay
;
Myoma
;
Uterus
10.Comparative Study of Laparoscopically Assisted Vaginal Hysterectomy (LAVH) and Total Laparoscopic Hysterectomy (TLH).
Korean Journal of Obstetrics and Gynecology 2005;48(1):143-152
OBJECTIVE: To compare the clinical results between laparoscopically assisted vaginal hysterectomy (LAVH) and total laparoscopic hysterectomy (TLH), and to realize the merits and demerits of both operations, so we know which pelviscopic hysterectomy operation is better method at the present time. METHODS: 30 of LAVH cases and 30 of TLH cases were performed from 12 December 2002 to 25 February 2004 at department of OB and GY, Dankook University Hospital. We analyzed the results with regard to patient's characteristics, indication of hysterectomy, size of uterus, operation time, blood loss, duration of hospitalization and complications. RESULTS: LAVH operations, and TLH operations were performed by same operator respectively. There were no significant differences in patient's characteristics (age, height, weight) between the two groups. The main preoperative indication was myoma uteri in both groups, followed by CINIII in LAVH groups and adenomyosis in TLH groups. The majority of uterine size on operation field was adult fist size in both groups. The mean operation time was 86.3 +/- 19.5 min for LAVH group and 153.3 +/- 44.4 min for TLH group, the operation time is significantly longer in TLH group (P-value<0.05). The blood loss was not significantly different between the two groups (265 +/- 92.9 mL for LAVH, 268 +/- 119.2 mL for TLH, P-value>0.05). The duration of hospitalization was not significantly different between the two groups (6.1 +/- 0.4 days for LAVH, 6.2 +/- 0.8 days for TLH, P-value>0.05). There is no complication in LAVH group, 3 complications in TLH group. CONCLUSION: LAVH has no significant differences in patient's characteristics, indication of operation, size of uterus, blood loss and duration of hospitalization, compared with TLH, but it has the merits of short operation time and less complication. In this study we consider that LAVH operation method stands at advantage over TLH.
Adenomyosis
;
Adult
;
Female
;
Hospitalization
;
Humans
;
Hysterectomy*
;
Hysterectomy, Vaginal*
;
Myoma
;
Uterus