Androgen insensitivity syndrome (AIS) / Philippine Journal of Obstetrics and Gynecology

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.

Herlyn Werner Wunderlich syndrome: A report of two cases / Philippine Journal of Obstetrics and Gynecology

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

Sealed off: A case of complete cervical and vaginal agenesis / Philippine Journal of Obstetrics and Gynecology

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.