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Hymenal Anomalies Interfering with Dilation in Women with Mullerian Agenesis: A Case Series
Chelsea Fortin1, Christine Pennesi2, Patricia S Huguelet3
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan.
Background:
Women with Mullerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), have aplasia or hypoplasia of the uterus and vagina. Regular use of dilators can successfully create a functional vagina in up to 95% of cases. We present 3 women with Mullerian agenesis who failed dilation therapy due to pain and were subsequently found to have hymenal anomalies.
Cases:
Patients presented at age 16 or 17 to initiate dilation. Initial attempts were discontinued due to pain. On examination, a septate hymen was identified in 2 patients and a microperforate hymen in 1 patient. All patients underwent hymenectomy and thereafter continued dilation with less discomfort.
Summary And Conclusion:
These cases illustrate the importance of recognizing and treating hymenal anomalies in women with Mullerian agenesis to prevent pain, leading to unsuccessful dilation.
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