Objective: This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic. Materials and Methods: MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care. Results: A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE. Conclusion The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.
COVID-19 ; Personal Protective Equipment ; Telemedicine

Androgen Insensitivity Syndrome (AIS) is a rare condition, it is an X-linked-mutation that is considered as a disease caused by resistance of androgen receptor to its actions. It is expressed in a variety of phenotypes ranging from male infertility to completely normal female external genitalia. This is a case of a 25 year-old with Complete Androgen Insensitivity Syndrome (CAIS), presented as phenotypical female with secondary sexual development, bilateral inguinal masses. Gonadectomy, estrogen replacement therapy and psychological support are part of long term management.

Human ; Female ; Adult ; Androgen-insensitivity Syndrome ; Ar Protein, Human ; Receptors, Androgen ; Estrogen Replacement Therapy ; Phenotype ; Infertility, Male ; Mutation ; Genes, X-linked ; Sexual Development ; Genitalia

A case of 17 year-old nulligravid who initially presented with a 3 year history of cyclic hypogastric pain with gradual abdominal enlargement. She was assessed with Imperforate Hymen and underwent hymenectomy and ultrasound-guided aspiration of blood clots per vagina. No vaginal canal was noted. Patient was subsequently lost to follow up.

Patient returned due to recurrence of hypogastric pain and enlargement of abdomen. Transrectal ultrasound revealed hematocolpos with hematometra. Assessment was Cervical and Vaginal Agenesis. Patient underwent exploratory laparotomy, total abdominal hysterectomy with bilateral salpingectomy.

According to American Fertility Society, there is no classification for a complex mullerian malformation such as mixed vaginal and cervical Agenesis. There is no reported case of mixed vaginal and cervical agenesis in the Philippines.

The best surgical management is still controversial. Conservative surgical method should be considered. A rare case of mixed vaginal and cervical agenesis is being presented where the management is a dilemma.

Human ; Female ; Adolescent ; Cervix Uteri-abnormalities ; Vagina-abnormalities

The association of renal agenesis with ipsilateral blind hemivagina and uterus didelphys is reported as Herlyn-Werner-Wundelich (HWW) syndrome. Presented herein are two cases of HWW syndrome, each with different set of clinical presentations but both with the same arranged diagnostic method and management executed. The first case, 15 year-old nulligravid, manifested severe dysmenorrhea since menarche and is worsening over the past months. On the other hand, the second case, 29 year-old Gravida 1 Para 0 (0010), exhibited cyclic hypogastric pain and gradually enlarging right pelvic mass. Both cases underwent computed tomography scan and ultrasound examination which revealed uterine didelphys, hemivagina obstruction and ipsilateral renal agenesis, yet each has different laterality of mullerian anomaly. Together were managed with full resection of the vaginal septum as well as drainage of the hematometrocolpos, which are, today, the main treatment for patients with HWW syndrome

Human ; Female ; Adult ; Adolescent ; Genitalia

Androgen insensitivity syndrome is a rare X-linked recessive androgen receptor defect seen in 1-5 of 100,000. It occurs in phenotypically normal women with adequate breast development, normal external genitalia, a vaginal of variable depth, absent uterus, and sparse or absent pubic hair and axillary hair. These patients have male karyotype (XY) and the gonads may be intra-abdominal, inguinal, or labial. This is a case of a 25-year old phenotypic female with primary amenorrhea, bilateral inguinal masses and a 46, XY karyotype. Following the diagnosis of complete androgen insensitivity syndrome, a multidisciplinary team, with the gynecologist as the primary physician, was formed. She underwent bilateral gonadectomy and was given continuous estrogen therapy and calcium supplementation. Pre-operative and post-operative supportive psychotherapy and continuous psychosocial support from her family and online AIS support groups played a major role in the positive adaptation of the patient. 

Human ; Androgen Insensitivity Syndrome (ais) ; Complete Androgen Insensitivity Syndrome (cais)

Androgen insensitivity syndrome is a rare X-linked recessive androgen receptor defect seen in 1-5 of 100,000. It occurs in phenotypically normal women with adequate breast development, normal external genitalia, a vagina of variable depth, absent uterus, and a sparse or absent pubic hair and axillary hair. These patients have male karyotype (XY) and the gonads may be intra-abdominal, inguinal, or labial. This is a case of a 25-year old phenotypic female with primary amenorrhea, bilateral inguinal masses and a 46, XY karyotype. Following the diagnosis of complete androgen insensitivity syndrome, a multidisciplinary team, with the gynecologist as the primary physician, was formed. She underwent bilateral gonadectomy and was given continuous estrogen therapy and calcium supplementation. Pre-operative and post-operative supportive psychotherapy and continuous psychosocial support from her family and online AIS support groups played a major role in the positive adaptation of the patient.

Human ; Androgen Insensitivity Syndrome (ais) ; Complete Androgen Insensitivity Syndrome (cais)

a cross sectional observational study was conducted to assess the knowledge, attitudes, and practices toward contraceptive methods and long acting reversible contraceptives in the outpatient clinic a tertiary government institution in Manila from June 1 to August 15,2014, 617 out of 659 reproductive aged women who participated in the study were included. Among participants, it is still the pill, which is the most popular mode of contraception across all age groups. Having fewer resources to purchase contraceptives does not hinder the use of supply contraceptive methods. Educational attainment, having atleast reached a college level of education of either the participant or partner improves the attitudes towards contraception and use of contraceptives including long acting reversible contraceptives.

Public health workers and media, by giving correct information to participants, improves the knowledge, attitude and practice toward the use of contraceptives including acceptability and use of long acting reversible contraceptives

Contraception ; Knowledge ; Attitude