Case Report: Laparoscopic Uterovaginal Anastomosis for Congenital Isolated Cervical Agenesis

Management of cervical agenesis is a challenge owing to the complexity of the malformation and the difficulty in restoring and preserving fertility. We propose a minimally invasive fertility-sparing surgery for a 17-year-old woman with congenital cervical agenesis and a normal vagina and uterus confirmed by vaginoscopy. The patient was admitted for primary amenorrhea, hematometra, and cyclic pelvic pain. She had undergone previous laparoscopies for ovarian endometriosis. Our surgical approach involved the creation of an isthmus-vaginal anastomosis with a uterovaginal reconnection. After surgery, the patient experienced regular menstrual cycles without dysmenorrhea. At 12 months postsurgery, she continued to experience normal menstruation, and the uterovaginal connection had not stenosed. Management of congenital cervical agenesis requires accurate diagnosis that includes appropriate classification of the malformation (European Society of Human Reproduction and Embryology/European Society for Gynaecological Endoscopy classification). Surgical treatment is controversial and depends on the patient's age and desire for resolution.