Prevalence of premalignant and malignant changes in hysteroscopically removed endometrial polyps in reproductive aged women: A 5-year review of cases in a Tertiary Government Hospital in the Philippines

Objective@#To determine the prevalence of premalignant and malignant changes in hysteroscopically removed endometrial polyps in reproductive aged women, and to determine clinical, ultrasonographic and hysteroscopic characteristics of such women. @*Methods@#This is a cross-sectional study of patients diagnosed with endometrial polyp, and underwent hysteroscopy from 2015-2019. A review of the medical records (ultrasound results, intraoperative findings and histopathology results) was done.@*Results@#A total of 117 patient records were included in the analysis. The median age of all patients who underwent hysteroscopy was 38 years old (age range: 19-44 years). The prevalence of endometrial hyperplasia or carcinoma in the 18-44 year old age group was 8.5% (n=10/117). Among patients with endometrial hyperplasia or carcinoma, 70% were nulligravid, 40% had anovulation disorder, and 40% had infertility. Most of the patients were overweight or obese (70%). Co-morbidities were present in only 3 cases, and diabetes mellitus (30%) was the predominant illness seen in these patients. @*Conclusion@#Our findings showed a higher prevalence (8.5%) of endometrial hyperplasia or carcinoma in endometrial polyps among Filipino reproductive-aged women, compared to reports in published literature. Among the different clinical characteristics, ultrasound and hysteroscopic findings, no particular factor had a significant association with endometrial hyperplasia or malignancy.

Practice of minimally invasive gynecologic surgery in the Philippines during the COVID-19 Pandemic / Philippine Journal of Obstetrics and Gynecology

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.