Abdominal surgical approach to a case of complete cervical and partial vaginal agenesis

Abstract

Objective: To construct a uterovaginal canal in a patient with a complete cervical agenesis and partial vaginal agenesis.

Design: Case report.

Setting: Zeynep Kamil Women's and Children Hospital.

Patient(s): A 15-year-old woman presented with lower abdominal pain. On examination, partial vaginal agenesis with a 4-cm vagina was noted. A pelvic ultrasonography revealed hematometra and the absence of a cervix.

Intervention(s): Surgical therapy included creation of an ostium by making 1.5-cm midline vertical hysterotomy incision, trimming away the fibrous tissue at the distal portion of uterus, and attaching the proximal end of the vagina to the uterus by the abdominal route. A stent was left in place for 2 weeks.

Main outcome measure(s): Pelvic ultrasonography and clinical follow-up evaluation.

Result(s): Regular menstrual periods were observed for 6 months beginning at the first month. The follow-up pelvic ultrasonography was normal.

Conclusion(s): Cervicoplasty attaching the mucosal lining of the endometrium to that of the vagina permits the creation of a patent cervical canal with short stenting time.