RESUMEN
OBJECTIVES: The objectives of the study were to compare the demographic characteristics, presenting complaints, timeliness of diagnosis, and treatments given to all patients diagnosed with obstructive hemivagina ipsilateral renal agenesis (OHVIRA) between the adolescent group (age 10-19) and the adult group (age 20 and above) and to propose a feasible screening test consisting of routine bedside ultrasound to detect renal anomalies in addition to pelvic ultrasound during the assessment of females with gynecologic complications in resource-limited settings. METHOD AND ANALYSIS: We conducted a retrospective cohort analysis of all patients with OHVIRA at our institution, Sabah Women and Children's Hospital, Malaysia, between the 2013 and 2022. Data were collected by reviewing patients' medical notes. RESULTS: There were a total of 18 patients diagnosed with OHVIRA from 2013 to 2022, aged 10-41 years old. Nine patients (50%) presented during adolescence. Most (88.9%) came with symptoms such as abdominal pain, urinary symptoms, abnormal uterine bleeding, foul-smelling vaginal discharge, and primary infertility, whereas only 2 patients (11.1%) were asymptomatic and diagnosed incidentally. Acute abdomen was more common in the adolescent group (P = .015). No significant difference was found on the side of the renal anomaly. CONCLUSION: Presenting symptoms vary and are often mimicked other gynecologic or surgical conditions, making the diagnosis difficult and delayed. Some patients were incidentally diagnosed while being managed for other problems, and it was not uncommon to have unnecessary surgery before the correct diagnosis was made. We suggest that all female patients with abdominal and pelvic complaints should be screened for renal anomaly during pelvic scan to improve diagnostic rates.
Asunto(s)
Anomalías Múltiples , Vagina , Niño , Adulto , Adolescente , Femenino , Humanos , Adulto Joven , Malasia , Estudios Retrospectivos , Vagina/anomalías , Anomalías Múltiples/cirugía , Riñón/diagnóstico por imagen , Riñón/anomalías , Síndrome , Útero/anomalíasRESUMEN
BACKGROUND: This study aimed to determine menstrual characteristics and related morbidities among adolescent girls living in Sabah, North Borneo, a less-developed state in Malaysia. METHODS: Data were obtained from a quantitative survey conducted in three government high schools located in Ranau, Sabah. The participants were adolescent girls who had attained menarche between the ages of 14 and 19. RESULTS: Based on the analysis of questionnaires completed by 757 adolescent girls, the mean age at the time of the survey was 17 ± 1.4 years, and the mean menarche age was 12.2 ± 1.1 years. Our data demonstrated that 85.7% of the participants experienced dysmenorrhoea, of which at least 42.1% (mean pain score ± SD: 4.81 ± 0.76, 95% confidence interval (CI) 4.72, 4.90) experienced moderate dysmenorrhoea, and 11.2% (mean pain score ± SD: 7.86 ± 0.94, 95% CI 7.64, 8.08) experienced severe dysmenorrhoea. Over 70% of these girls complained of tiredness, headache, and appetite changes during menses. CONCLUSIONS: The prevalence of menstrual disorders and related morbidities was high among the girls residing in Sabah. Reproductive health issues in rural and socioeconomically deprived areas remains poorly addressed. The main consequence of neglecting menstrual disorders and their related morbidities is impaired future sexual reproductive health in adults. Thus, addressing adolescent reproductive health issues is crucial, especially for girls living in areas where access to healthcare is difficult. The information gathered from this study can be used to strategize effective interventions to improve adolescents' reproductive health status in rural areas.
Asunto(s)
Dismenorrea , Síndrome Premenstrual , Adolescente , Adulto , Borneo , Niño , Estudios Transversales , Dismenorrea/epidemiología , Femenino , Humanos , Malasia/epidemiología , Trastornos de la Menstruación/epidemiología , Prevalencia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Congenital neonatal uterovaginal prolapse is a rare occurrence that is usually detected after delivery. Most cases are managed conservatively, although there are more invasive approaches to management. We report a case of a neonate with uterovaginal prolapse that we successfully managed conservatively. In this case, a vaginal plug made from a wet cotton ball and condom was inserted into the vaginal canal. To further reinforce the vaginal plug, a pressure garment was applied over the neonate's diaper. A trial of noninvasive methods that are simple and cost-effective should always precede other, more invasive methods in managing cases such as this.