Obstructed uterovaginal anomalies: demonstration with sonography. Part II. Teenagers

The sonograms of 13 patients with obstructed uterovaginal anomalies were reviewed to determine the role of sonography in diagnosis and management. In a retrospective analysis, the authors were able to define the cause of the obstruction and the upper level and length of the obstruction by combining the sonographic findings with those from the physical examination (ie, bulging hymen, blind vaginal pouch, no vaginal depth, normal vagina) or by combining transabdominal sonography with simultaneous digital insertion into the vaginal orifice. When the sonogram demonstrated hematometrocolpos or hematocolpos, the lesion was due to an imperforate hymen (n = 1) or high, middle, or low transverse vaginal septum (n = 7). When the sonogram demonstrated a hematometra, the lesion was due to Mayer-Rokitansky-Küster-Hauser syndrome with functioning uterine anlage(n) (n = 2), cervical dysgenesis (n = 1), and an obstructed uterine horn (n = 2). The presence and patency or absence of the cervix was established. Since the differentiation between a transverse vaginal septum, Mayer-Rokitansky-Küster-Hauser syndrome with active anlagen, and cervical dysgenesis with absent vagina cannot be made clinically, sonography provides important presurgical information.