Premature pubarche is the development of pubic hair without the development of other secondary sexual chacteristics before the age of 8 in girls. Traditionally, considered to be benign, premature pubarche has been associated with polycystic ovarian syndrome and the metabolic syndrome. This is the case of a 7-year-old female with warty lesions on the right thumb and labia majora, and an incidental finding tanner stage 2 pubic hair. 17-OHP and testosterone levels were normal, DHEAS level at the pubertal range. Her clinical profile places her at risk, and as such, monitoring is warranted for early detection of polycystic ovarian syndrome and metabolic syndrome in the future.
Human ; Female ; Child ; POLYCYSTIC OVARY SYNDROME ; WARTS

OBJECTIVE: To evaluate the patient characteristics, and clinical outcomes of the total laparoscopic hysterectomy procedures performed in the Philippine General Hospital from January 2011 to June 2014.

STUDY DESIGN: Retrospective cross sectional study.

METHODS: The medical records of all patients admitted for an elective total laparoscopic hysterectomy in PGH from January 2011 to June 2014 were reviewed. Patients' demographic data, intraoperative and postoperative outcomes and complications were extracted and analyzed.

RESULTS: Data for 67 patients were analyzed. The patients operated on were mostly parous, premenopausal (94%) women with a mean age of 46.3 years, and a BMI of 23.2 kg/m2. Most of the women were admitted for uterine fibroids (55.2%), adenomyosis (26.9%), and benign ovarian new growths (9.0%). Fifteen surgeries were converted to laparotomy (22.4% failure rate). Majority (93.3%) of the conversions were due to technical difficulty in performing the hysterectomy. The mean uterine height was 10.8 cm, and mean uterine width was 8.4 cm. The mean operation time of the converted group (207.7 mins) was comparable to the TLH group (235.6 mins). The estimated blood loss for the TLH group (337.5 cc) was significantly less than that of the converted group (556.7 cc). The mean hospital and postoperative stay of the patients were 4.7 days and 2.4 days, respectively. The only intraoperative complication documented was hemorrhage (n=3). There were 2 minor postoperative complications noted (3%).

CONCLUSION: The patients who successfully underwent a TLH procedure were mostly parous, non-obese, premenopausal women, with non-bulky uterine sizes. Mayoma uteri and adenomyosis were the most common indications for surgery. Patients who underwent successful TLH had significantly less intraoperative bloss loss compared to patients whose surgeries were converted to laparotomy.

Human ; Female ; Hysterectomy ; Laparoscopy