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Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis
Ayse Gurbuz1, Ates Karateke, Berna Haliloglu
1Gynecologic Oncology and Pelvic Reconstructive Surgery Unit, Zeynep Kamil Women's and Children Hospital, Uskudar, Istanbul, Turkey. bernadr23@hotmail.com
Objective:
To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis.
Design:
Case report.
Setting:
Zeynep Kamil Women's and Children Hospital.
Patient(S):
A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix.
Intervention(S):
Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks.
Main Outcome Measure(S):
Pelvic ultrasonography and clinical follow-up evaluation.
Result(S):
Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal.
Conclusion(S):
Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time.
