Conservative surgery is the treatment of choice for pelvic endometriosis. However, one of the most frustrating aspects of treating pelvic endometriosis is disease recurrence. As endometriotic tissue is hormonally sensitive, postoperative cyclic or continuous low dose monophasic oral contraceptive pills may be effective in preventing or delaying recurrence. Our results showed no statistically significant difference between the recurrence rates of patients who were cyclic or continuous OCP users. Symptom and bigger anatomic recurrences were observed among cyclic OCP users. Post operative OCP use and duration of treatment did not significantly influence time to disease recurrence. The risk of recurrence of endometriotic cyst seemed higher among cyclic OCP users. Further, statistically powered randomized controlled trials with bigger sample size, long term use and longer follow up period are necessary to better provide recommendations regarding the OCP administration regimen.
Human ; ENDOMETRIOSIS ; RECURRENCE ; PELVIC PAIN ; LAPAROSCOPY ; CONTRACEPTIVES, ORAL

The Mayer Rokitansky Kuster Hauser Syndrome (MRKHS) is characterized by congenital absence of the uterus and the middle to upper thirds of the vagina. Women with this syndrome are genotypically female presenting with primary amenorrhea, female secondary sexual characteristics, normal ovarian function, absent or short blind vagina and the presence of uterine remnants or rudimentary uteri. The occurrence of leiomyoma in a patient with MRKHS arising from the fibromuscular tissues of uterine remnants is very rare. As the mullerian ducts have smooth muscles, the presence of a myoma is a possibility. This paper aims to explain the pathogenesis of leiomyoma arising from the uterine remnants in patients with MRKHS and to present a comprehensive review on the clinical presentation, diagnostic evaluation, and management of this condition. There is paucity of documented cases of leiomyoma associated with MRKHS reported in literature. This is a the first case reported locally.
MAYER ; ROKITANSKY ; KUSTER HAUSER ; SYNDROME ; MULLERIAN ; AGENESIS ; PRIMARY ; AMENORRHEA ; LEIOMYOMA ; UTERI

Objective: To determine the knowledge, attitude and practice involved in the decision making on prophylactic oophorectomy among women awaiting hysterectomy for a benign disease. Methods: Pre-menopausal women scheduled for hysterectomy in a tertiary government hospital were interviewed regarding their views on prophylactic oophorectomy, menopause and hormone replacement therapy. Results: Seventy percent of women consented to outright hysterectomy with bilateral salpingoophorectomy. Almost half (49%) of the women consenting to oophorectomy have no idea as to the benefits of retaining the ovaries after a hysterectomy. Some women (14%) talked about the long term outcome of oophorectomy such as prevention of ovarian cancer but no women mentioned osteoporosis, breast or cardiac disease and dementia. Others (19%) expressed the fear of having another disease on the ovaries if it will be left behind. Majority of women had no idea about menopause and hormone replacement therapy. Sixty percent of the women left the major influence in making the decision to undergo hystertomy alone or oophorectomy with hysterectomy to their physicians. Conclusion: Most these women are under-informed regarding the benefits the benefits or disadvantages of retaining or removing the ovaries, menopause and hormone replacement therapy. It has become a routine practice to recommend oophorectomy based on age alone. Women who consented to outright oophorectomy relied on the decision of their physicians to proceed with the surgery. In this day and age, patients are far less empowered with information that will make them assume the role of a primary decision maker.
Human ; Female ; Middle Aged ; Adult ; OVARIECTOMY ; MENOPAUSE ; HORMONE REPLACEMENT THERAPY

OBJECTIVE: To determine the knowledge, attitude and practice involved in the decision making on prophylactic oophorectomy among women awaiting hysterectomy for a benign disease.

METHODS: Pre-menopausal women scheduled for hysterectomy in a tertiary government hospital were interviewed regarding their views on prophylactic oophorectomy, menopause and hormone replacement therapy.

RESULTS: Seventy percent of women consented to outright hysterectomy with bilateral salpingoophorectomy. Almost half (49%) of the women consenting to oophorectomy have no idea as to the benefits of retaining the ovaries after a hysterectomy. Some women (14%) talked about the long term outcome of oophorectomy such as prevention of ovarian cancer but no women mentioned osteoporosis, breast or cardiac disease and dementia. Others (19%) expressed the fear of having another disease on the ovaries if it will be left behind. Majority of women had no idea about menopause and hormone replacement therapy. Sixty percent of the women left the major influence in making the decision to undergo hystertomy alone or oophorectomy with hysterectomy to their physicians.

CONCLUSION: Most these women are under-informed regarding the benefits the benefits or disadvantages of retaining or removing the ovaries, menopause and hormone replacement therapy. It has become a routine practice to recommend oophorectomy based on age alone. Women who consented to outright oophorectomy relied on the decision of their physicians to proceed with the surgery. In this day and age, patients are far less empowered with information that will make them assume the role of a primary decision maker.

Human ; Female ; Middle Aged ; Adult ; Ovariectomy ; Menopause ; Hormone Replacement Therapy