Reconstrucción vaginal utilizando tejido de la vejiga urinaria en una paciente con complejo OEIS: reporte de un caso

D R Winograd1, T L Wassmer1, M R Daugherty2

  • 1Division of Pediatric & Adolescent Gynecology, Department of Surgical Services, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Resumen

Este estudio de caso detalla una rara anomalía del complejo OEIS donde las hemivaginas se conectan a la vejiga. Se utilizó tejido de la vejiga urinaria para crear con éxito una neovagina, preservando las estructuras de Müller. Los resultados principales incluyen la separación exitosa de los tractos reproductivo y urinario, el mantenimiento de los sistemas de Müller y la creación de una neovagina con tejido de la vejiga urinaria. El propósito de este estudio fue presentar un caso único de complejo OEIS con desafíos anatómicos específicos, describir un enfoque quirúrgico novedoso para la creación de neovagina y resaltar la utilidad del tejido de la vejiga urinaria en la cirugía reconstructiva para el complejo OEIS. El complejo OEIS (onfalocele, exstrofia cloacal, ano imperforado y anomalía espinal) es un defecto congénito grave, a menudo asociado con anomalías de Müller y genitales externos duplicados. La creación de neovagina en estos pacientes depende de la extensión de la malformación, la disponibilidad de tejido, la edad y las estructuras de Müller funcionales. Los métodos principales incluyeron la presentación de un paciente con diagnóstico de complejo OEIS, la descripción detallada de hemivaginas bilaterales que desembocan en la placa de la vejiga y la técnica quirúrgica que utiliza tejido de la vejiga urinaria para separar los tractos reproductivo y urinario. Las conclusiones son que este caso demuestra una conexión inusual entre la vejiga y las hemivaginas en el complejo OEIS, el tejido de la vejiga urinaria demostró ser una opción viable para la construcción de neovagina y el enfoque quirúrgico mantuvo la integridad esencial de los sistemas reproductivo y urinario. El área de ciencia es medicina reproductiva, cirugía pediátrica y anomalías congénitas.

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