Mullerianosis is a rare, benign, and morphologically complex, tumor-like lesion that consists of an organoid structure with normal Müllerian tissue. The diagnosis requires the presence of at least two of the three mullerian tissues: endometriosis, endosalpingiosis, and endocervicosis. There are only less than twenty (20) cases reported in literature. At present there is no published case report of mullerianosis here in the Philippines. This is a case report of a 30-year old Filipino woman who presented predominantly with lower urinary tract symptoms of severe dysuria, hematuria, and lumbar pain and was evaluated for a urologic problem secondary to a posterior bladder mass. Subsequent evaluations revealed the diagnosis of mullerianosis. This is where the interest in mullerianosis sets, its potential to mimic a neoplastic lesion of the urinary tract from clinical and diagnostic viewpoints. The clinical importance to diagnose this case correctly is of grave importance for appropriate management.

Human ; Female ; Dysuria ; Endometriosis ; Fallopian Tube Diseases ; Hematuria ; Lower Urinary Tract Symptoms ; Neoplasms ; Organoids ; Pain ; Philippines ; Urinary Bladder Diseases

Abscess ; surgery ; Adult ; Aged ; Aged, 80 and over ; Cysts ; surgery ; Drainage ; methods ; Endometriosis ; surgery ; Fallopian Tube Diseases ; surgery ; Female ; Humans ; Middle Aged ; Ovarian Cysts ; surgery ; Pelvis ; surgery ; Retrospective Studies ; Surgery, Computer-Assisted ; Tertiary Care Centers ; Treatment Outcome ; Ultrasonography ; Ultrasonography, Interventional ; methods ; Vagina ; Young Adult

INTRODUCTIONThis retrospective study was conducted to perform an external validation of the in vitro fertilisation (IVF) predict model developed by Scott Nelson et al in an Asian population.

MATERIALS AND METHODSAll IVF cycles registered in the study centre from January 2005 to December 2010 were included. Observed and predicted values of at least 1 live birth per cycle were compared by discrimination, calibration. Hosmer-Lemeshow test was used to assess the goodness-of-fit of the model calibration and Brier score was used to assess overall model performance.

RESULTSAmong 634 IVF cycles, rate of at least 1 live birth was 30.6%. Causes of infertility were unexplained in 35.5% cases. Fifty-seven percent of women came for their first IVF treatment. First IVF cycle showed significantly higher success in comparison to subsequent cycles. The odds ratio of successful live birth was worse in women with endometriosis. Observed outcome was found to be more than the prediction of the model. The area under the curve (AUC) in this study was found to be 0.65 that was close to that of Nelson model (0.6335) done in internal validation. Brier score (average prediction error) of model was 0.2. Chi square goodness-of-fit test indicated that there was difference between the predicted and observed value (x² =18.28, df = 8, P = 0.019). Overall statistical findings indicated that the accuracy of the prediction model fitted poorly with the study population.

CONCLUSIONOvarian reserve, treatment centre and racial effect on predictability cannot be excluded. So it is important to make a good prediction model by considering the additional factors before using the model widely.

Adolescent ; Adult ; Anovulation ; complications ; Area Under Curve ; Asian Continental Ancestry Group ; Endometriosis ; complications ; Fallopian Tube Diseases ; complications ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; etiology ; therapy ; Infertility, Male ; therapy ; Live Birth ; Male ; Maternal Age ; Odds Ratio ; Pregnancy ; Pregnancy Rate ; Reproducibility of Results ; Reproductive History ; Retrospective Studies ; Singapore ; Treatment Outcome ; Young Adult

Fallopian Tube Diseases ; therapy ; Female ; Humans ; Infertility ; therapy ; Medicine, Chinese Traditional

Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention.
Abscess ; Adnexa Uteri ; Diagnosis ; Emergency Service, Hospital ; Endometriosis ; Fallopian Tube Diseases ; Female ; Humans ; Ovarian Cysts ; Ovary ; Pelvic Pain* ; Pregnancy ; Radiation, Ionizing ; Ultrasonography*

Choristoma ; pathology ; Fallopian Tube Diseases ; pathology ; Fallopian Tubes ; pathology ; Female ; Humans ; Uterus

In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.
Aged* ; Biopsy ; Diagnosis, Differential ; Endometriosis ; Epithelium ; Fallopian Tube Diseases ; Fallopian Tubes ; Female ; Gynecology ; Humans ; Incidental Findings ; Infertility ; Laparotomy ; Menopause ; Ovary ; Pathology ; Pelvic Pain ; Physical Examination ; Thorax ; Uterine Hemorrhage

OBJECTIVE: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. METHODS: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. RESULTS: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. CONCLUSION: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.
Abortion, Spontaneous ; Fallopian Tube Diseases ; Female ; Humans ; Hysterosalpingography ; Infertility ; Insemination ; Medical Records ; Pregnancy ; Pregnancy Rate ; Pregnancy, Ectopic ; Retrospective Studies ; Sterilization, Tubal ; Superovulation

OBJECTIVETo study the effect and mechanism of Bushen Tiaojing Recipe on improving oocyte and embryo qualities in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) at the super-ovulatory cycle.

METHODSFifty-eight tubal infertility patients undergoing IVF-ET were randomly assigned to two groups. Thirty patients in the treatment group were treated with Bushen Tiaojing Recipe and GnRHa/FSH/hCG, and twenty-eight patients in the control group were treated with GnRHa/FSH/hCG. Contents of GDF-9 in the mature follicular fluid were detected by Western blot. The expressions of GDF-9 in granulose cells were detected by Real-time PCR. The dose of gonadotropin (Gn), the number of oocytes obtained, the fertilization rate, the oocyte cleavage rate, the high quality embryo rate, and the pregnancy rate were compared.

RESULTSThe contents of GDF-9 in the follicular fluid and its expression in granulosa cells were significantly higher in the treatment group than in the control group (P<0.05). The number of oocytes obtained, the fertilization rate, the high quality embryo rate, and the pregnancy rate were significantly higher in the treatment group than in the control group. There was no significant difference in the dose of Gn or the oocyte cleavage rate.

CONCLUSIONSBushen Tiaojing Recipe could improve the pregnancy rate of IVF-ET. Its mechanism might be possibly through regulating the GDF-9 contents in the follicular fluid and granulosa cells.

Adult ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Embryo Transfer ; Fallopian Tube Diseases ; complications ; Female ; Fertilization in Vitro ; Granulosa Cells ; drug effects ; metabolism ; Growth Differentiation Factor 9 ; metabolism ; Humans ; Infertility, Female ; etiology ; metabolism ; therapy ; Phytotherapy ; Young Adult

Adenoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Cystadenocarcinoma ; pathology ; Cystitis ; metabolism ; pathology ; Endometriosis ; immunology ; pathology ; Fallopian Tube Neoplasms ; pathology ; Female ; Humans ; Intestines ; pathology ; Keratin-7 ; metabolism ; Male ; Metaplasia ; pathology ; Racemases and Epimerases ; metabolism ; Urinary Bladder Neoplasms ; metabolism ; pathology ; Uterine Diseases ; immunology ; pathology