Background: Uterine fibroids are the most common benign tumors in women. Management of symptomatic fibroids may ultimately require surgery and for those desirous of fertility, laparoscopically assisted myomectomy and the conventional laparoscopic procedure are conservative treatment options, with the former providing a less technically demanding approach. Objectives: This study aims to evaluate the clinical outcomes for laparoscopically assisted myomectomy (LAM) versus laparoscopic myomectomy (LM) done at a tertiary hospital. Methods: This is a retrospective chart review of 118 patients with symptomatic myomas who underwent LM (n=66) or LAM (n=52) at a tertiary hospital from January 2010 to December 2017. Results: There were significantly more fibroids removed in the LAM group compared to the LM group, but with no significant difference in the average diameter of fibroid removed. Complex plastic reconstruction with more than 2 layers of repair was done more often in the LAM group (p<0.001). The mean operative time was longer and more blood loss was incurred in the LM group, but this was not statistically significant. Almost 14% of patients in the LM group had blood transfusion compared to 4.1% in the LAM group (p=0.085). The rate of perioperative complications was similar for both groups. The length of hospital stay was shorter in the LM group, but was not statistically significant. A trend towards higher odds of pregnancy was seen in the LAM group. Majority of patients were delivered via cesarean section with no incidence of uterine rupture. The recurrence of fibroids was seen more in the LAM group (17.9% versus 13.7% for LM), however this was not statistically significant. Conclusions The surgical, reproductive, and long-term clinical outcomes for both LAM and LM are similar, thus, LAM provides a non-inferior minimally invasive approach and a conservative option for patients desirous of future fertility.
Uterine Myomectomy ; Laparoscopy

Screening all postmenopausal women for low bone mineral density by dual-energy x-ray absorptiometry (DXA) is currently not recommended and not cost-effective. Risk factors for osteoporosis are evaluated to develop a simple tool for identifying those at increased risk and therefore should undergo further bone mineral density testing by DXA.

MATERIALS AND METHODS: Records of postmenopausal Filipino women, who had BMD measurements by DXA in the Department of Nuclear Medicine in a tertiary hospital from January 2010 to December 2010, were reviewed. Scores computed based on each of the three clinical prediction rules (ABONE, OST, NOF) were compared with their corresponding T-scores obtained from DXA machine. Validity of the osteoporosis risk indices was evaluated. Logistic regression analysis and receiver operating characteristic analysis were used to identify the simplest tool that would classify subjects at increased risk for low BMD.

RESULTS: The study population composed of 514 postmenopausal Filipino women with a mean age of 60 years, with DXA data for the femoral neck. The following were the results obtained regarding the validity of each of the clinical prediction rule: ABONE 92.9% specific, 20.9% sensitive, positive predictive value of 80.8%; OST 31.6% specific, 88.7%sensitive, positive predictive value of 64.9%; NOF 49.5% specific, 79.1% sensitive, positive predictive value of 69.1%. A simple algorithm based on the age and body mass index (BMI) was developed. Age, BMI osteoporosis scoring tool 59.4%specific, 67.2%sensitive, positive predictive value of 70.2%. Based on the newly developed age, BMI osteoporosis scoring tool, patients with score of 3 or more is likely three times at risk of low bone mineral density.

CONCLUSION: Based on the data gathered and analyzed, a higher percentage of osteopenia/osteoporosis was seen in the elderly (aged 66-84yrs) and in those with low BMI. These two variables performed fairly well in identifying postmenopausal Filipino women at risk for osteoporosis, hence the development of age, BMI osteoporosis scoring tool. Other clinical prediction rules including (ABONE, OST and NOF) evaluated in Caucasians and other Asian women also performed well in postmenopausal Filipino women.

Human ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Absorptiometry, Photon ; Femur Neck ; Bone Density ; Postmenopause ; Osteoporosis ; Asian Continental Ancestry Group

Two women presenting with recurrent pregnancy loss were both diagnosed to have septate uterus. After hysteroscopic resection of the septum under laparoscopic guidance, successful term pregnancy was achieved in one patient, while second patient is currently on her 24th week of gestation. Septate uterus is the most common type of congenital uterine anomaly and has long been known to be associated with recurrent miscarriages, late-term abortion, and preterm labor. The pre-treatment abortion rate is 90%, which is both distressing for the patient and frustrating for the physician. Hysteroscopic septal resection under laparoscopic guidance is considered the standard for treatment, and is shown to improve reproductive outcome.
ANOMALY ; SEPTATE UTERUS ; RECURRENT PREGNANCY LOSS

Objective: To characterize the semen quality of Filipino male partners of couples with infertility and determine the effects of age. Design: Retrospective study. Setting: Andrology laboratory at a tertiary care hospital. Patients: 2,701 males. Main Outcome Measures: Routine semen analysis. Results: Average age of the study population was older and azoospermia occurence was lower than in previous studies. A large proportion had parameters below the WHO reference values. A decreasing trend for all semen parameters across increasing age was observed. For males -51 years old almost all parameters were below WHO values. Subject with abnormal parameters were significantly increasing across age. Occurence of severe oligozoospermia in older males was significantly increased compared to younger males. Conclusion: The study characterized the current status of semen quality in this subpopulation, a very large proportion of which had values below WHO reference. The data illutrate that as men age, semen quality declines.
Human ; Male ; Middle Aged ; Adult ; Young Adult ; SEMEN ANALYSIS ; MALE

OBJECTIVE: To characterize the semen quality of Filipino male partners of couples with infertility and determine the effects of age.

DESIGN: Retrospective study.

SETTING: Andrology laboratory at a tertiary care hospital.

PATIENTS: 2,701 males.

MAIN OUTCOME MEASURES: Routine semen analysis.

RESULTS: Average age of the study population was older and azoospermia occurence was lower than in previous studies. A large proportion had parameters below the WHO reference values. A decreasing trend for all semen parameters across increasing age was observed. For males -51 years old almost all parameters were below WHO values. Subject with abnormal parameters were significantly increasing across age. Occurence of severe oligozoospermia in older males was significantly increased compared to younger males.

CONCLUSION: The study characterized the current status of semen quality in this subpopulation, a very large proportion of which had values below WHO reference. The data illutrate that as men age, semen quality declines.

Human ; Male ; Middle Aged ; Adult ; Young Adult ; Semen Analysis ; Male