Erschienen in:
01.10.2014 | Original Article
Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty
verfasst von:
Sundeep Kisku, Lilly Varghese, Aruna Kekre, Sudipta Sen, Sampath Karl, John Mathai, Reju Joseph Thomas, Ravi Kishore Barla
Erschienen in:
Pediatric Surgery International
|
Ausgabe 10/2014
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Abstract
Background
Cervicovaginal atresia is a rare Mullerian anomaly. The management of cervicovaginal atresia has evolved from historical recommendations of hysterectomy to various reconstructive procedures more recently. The latter carries a risk of significant morbidity and unknown fertility. We present our experience in the management of this complex anomaly.
Methods
Twenty patients with cervicovaginal atresia were operated in our hospital from January 2004 through December 2013. The details of their anatomical variations and functional outcomes were analyzed.
Results
Eighteen out of twenty patients had cervical agenesis. Two patients had cervical hypoplasia. All patients underwent utero-coloneovaginoplasty. Post operatively, all patients have regular menstrual cycles. One patient is married, sexually active and has satisfactory coital function. One patient had a bowel anastomotic leak that required a diversion ileostomy. Two patients developed mild stenosis. One patient has mild neovaginal mucosal prolapse. No patient has developed pyometra.
Conclusion
Patients with cervicovaginal atresia need to be counselled about the various reconstructive options available and the potential risks. Social and economic factor play a significant role in determining the plan of management. For patients from conservative societies, utero-coloneovaginoplasty provides a safe conduit for the passage of menstrual flow and coitus, at the cost of permanent infertility.