A premenopausal woman witj multiple risk factors for endometrial cancer, diagnosed with giant endometrial polyp with benign features on preoperative biopsy is presented. On hysteroscopy, intraoperative frozen section revealed a benign polyp, but was malignant on final histopathology. Definitive surgery yielded simple hyperplasia and endometrial polyp. Giant endometrial polyp grows to 9-12cm diameter. Complications in hysterosocopic removal of giant polyps are higher risk of perforation, more blood loss, hyponatremia, pulmonary edema, and hyperglycemia. All associated with dificult visualization and prolonged surgery. Frozen section of endometrial mass may help in instituting appropriate treatment. Local studies show high accuracy, although some reports were conflicting. In case of malignancy, maintenace of intrauterine pressure distention to less than 70mm Hg prevents dissemination of cancer cells. The hyperestogenic state seen in obesity with uncontrolled hypertension, diabetes, nulliparity and vaginal bleeding were associated in developing endometrial cancer arising from endometrial polyp resected by hysteroscopy.
Human ; Female ; Middle Aged ; CARCINOMA, ENDOMETRIOID ; HYSTEROSCOPY ; ENDOMETRIAL NEOPLASMS

OBJECTIVE: This study aimed to determine the factors that result in stress for Filipino women with infertility. It sought to gain knowledge about the potentially serious implications of infertility on their psychological and emotional health to aid in formulation of a more structured program of counseling.

MATERIALS AND METHODS: This is a prospective descriptive study utilizing a validated Fertility Problem Inventory (FPI) tool translated in Filipino. The study population consisted of 35 women aged 21-40 years who consulted at the infertility clinic of a tertiary hospital with at least 12 months of unsuccessful attempts at conceiving.

RESULTS: The mean global stress score was 163.03 (+SD 14.13.). Age, number of infertile years, educational attainment, occupation, cause of infertility, and number of years trying to conceive did not significantly contribute to the global stress. Infertility related stress involving social concerns and need for parenthood were significantly greater than the others. Patients with less educational attainment had higher infertility related stress when it comes to sexual concerns. Patients with shorter duration of infertility had more stress related to attitude towards having a childfree lifestyle. Patients with longer duration of infertility had greater stress with the need for parenthood.

CONCLUSION: Filipino female patients were found to have elevated global stress scores using FPI. FPI is a useful tool in identifying patients with infertility related stress and facilitation of subsequent referral to Psychiatry. It should be part of the initial evaluation of infertility patients. It identifies specific concerns that are useful in counseling.

Human ; Female ; Adult (a Person 19-44 Years Of Age) ; Infertility ; Psychology ; Health ; Female ; Patients ; Hospitals

OBJECTIVE

This study aimed to determine the factors that result in stress for Filipino women with infertility. It sought to gain knowledge about the potentially serious implications of infertility on their psychological and emotional health to aid formulation of a more structured program of counseling.

MATERIALS AND METHODS

This is a prospective descriptive study utilizing a validated Fertility Problem Inventory (FPI) tool translated in Filipino. The study population consisted of 35 women aged 21-40 years who consulted at the infertility clinic of a tertiary hospital with at least 12 months of unsuccessful attempts at conceiving.

RESULTS

The main global stress score was 163.03 (+SD 14.13). Age, number of infertile years, educational attainment, occupation, cause of  infertility, and number of years trying to conceive did not significantly contribute to the global stress. Infertility related stress involving social concerns and need for parenthood were significantly greater than the others. Patients with less educational attainment had higher infertility related stress when it comes to sexual concerns. Patients with shorter duration of infertility had more stress related to attitude towards having a  childfree lifestyle. Patients with longer duration of infertility had greater stress with the need for parenthood.

CONCLUSION

Filipino female patients were found to have elevated global stress scores using FPI. FPI is a useful tool in identifying patients with infertility related stress and facilitation of subsequent referral to Psychiatry. It should be part of the initial evaluation of infertility patients. It identifies specific concerns that are useful in counseling.

Human ; Female ; Infertility

A 21-year old commercial sex worker, G2P1(0101) presented at 20·21 weeks of gestation with a rapidly enlarging infected cauliflower-like vulvar mass. Infection and anemia were managed and followed by surgical excision of the vulvar mass. One week postoperatively, intrauterine fetal demise occurred and the patient delivered spontaneously after 2 weeks (beginning tumor regrowth was seen at this time). Preliminary histopathologic findings showed Condyloma acuminata and treatment with an immune modifier cream was started but there was no response. Further evaluation of histopathologic result led to the final diagnosis of giant Condyloma acuminata of Buschke and Lowenstein/Verrucous carcinoma. There was rapid enlargement of the tumor in six weeks, despite medical treatment, with enlargement of bilateral inguinal lymph nodes. A radical vulvectomy with bilateral groin node dissection was done.This successfully treated the tumor with no recurrence on her 6th month follow up.

Human ; Female ; Adult ; Groin ; Vulvectomy ; Sex Work ; Buschke-lowenstein Tumor ; Carcinoma, Verrucous ; Condylomata Acuminata ; Vulva ; Lymph Nodes ; Anemia ; Fetal Death ; Brassica