Double uteri with cervicovaginal agenesis

Area of Science:

• Reproductive Medicine
• Surgical Innovation
• Anatomical Classification

Background:

• Complex genital tract malformations present significant management challenges.
• Accurate description and classification are crucial for effective treatment planning.
• Existing classifications may not fully capture the complexity of these anomalies.

Observation:

• A case report details the surgical management of a patient with complex genital malformation.
• Interventions included laparotomy, double hysterectomy, and vaginal reconstruction using bilateral neurovascular pudendal thigh flaps.
• The novel vaginal, cervix, uterus, adnexa-associated malformation (VCUAM) classification was employed to describe the anomaly.

Findings:

• Surgical reconstruction resulted in a patent and sensate neovagina, preserving erogenous zone innervation and relieving pelvic pain.
• The VCUAM classification proved effective in precisely depicting complex anatomical variations.
• Bilateral neurovascular pudendal thigh flaps provided a successful method for vaginal reconstruction.

Implications:

• Vaginal reconstruction using pudendal thigh flaps offers a viable surgical option with positive postoperative results.
• The VCUAM classification provides a standardized and accurate method for describing complex genital tract malformations.
• This approach may improve diagnostic accuracy and guide surgical strategies for similar cases.