Laparoscopic Management of Cervical Agenesis: A Rare Case Report

Area of Science:

• Reproductive Medicine
• Minimally Invasive Surgery
• Pediatric Gynecology

Background:

• Congenital obstructive Mullerian anomalies are rare conditions affecting the female reproductive tract.
• Partial vaginal aplasia and cervical agenesis present unique diagnostic and management challenges.
• Cyclic pelvic pain in adolescents can be an indicator of underlying Mullerian anomalies.

Purpose of the Study:

• To describe the successful laparoscopic management of a rare case of partial vaginal aplasia and cervical agenesis.
• To illustrate the technique of direct laparoscopic utero-vaginal anastomosis for restoring genital tract continuity.
• To highlight the importance of a multidisciplinary approach in managing complex Mullerian anomalies.

Main Methods:

• A 13-year-old female with cyclic pelvic pain and suspected Mullerian anomaly underwent diagnostic imaging.
• Laparoscopic evaluation revealed partial vaginal aplasia, cervical agenesis, and a hematometra.
• A direct laparoscopic utero-vaginal anastomosis was performed to reconstruct the genital tract.

Main Results:

• The patient experienced immediate postoperative pain relief.
• Post-procedure vaginoscopy and hysteroscopy confirmed a patent utero-vaginal canal and uterus.
• At 2-year follow-up, the patient reported regular, painless menstrual cycles with no signs of stenosis.

Conclusions:

• Laparoscopic utero-vaginal anastomosis is an effective treatment for cervical agenesis with partial vaginal aplasia.
• Long-term follow-up is essential to monitor for complications and assess fertility potential.
• Multidisciplinary collaboration is crucial for optimal management of rare Mullerian anomalies.