The epidemiology and management of gynatresia in Lagos, southwest Nigeria

Abstract

Objective: To document data from patients presenting with gynatresia at 2 tertiary health centers in Lagos, southwest Nigeria.

Methods: In a prospective, descriptive study, clinical history and physical examination data were collected for women who presented with gynatresia between January 2004 and January 2011. Ultrasonography results and abnormality at surgery were also documented. Where possible, the severity of stenosis and surgical outcome were assessed by published scales.

Results: Forty-seven patients were included in the study. Eight patients (17.0%) presented with congenital gynatresia, the commonest cause of which was Mayer-Rokitansky-Küster-Hauser syndrome (4 patients, 50%). Thirty-nine patients (83.0%) presented with acquired gynatresia, the main cause of which was herbal pessaries (30 patients, 76.9%). Herbal pessaries were used to treat fibroids (23 patients, 76.7%), uterovaginal prolapse (3, 10.0%), and infertility (2, 6.7%); and to procure abortion (2, 6.7%). The ages of the patients who used herbal pessary ranged from 18 to 50 years (mean 36.10 ± 1.24 years). Other causes of acquired gynatresia were birth injuries (6 patients, 15.4%), and female genital mutilation (2, 5.1%).

Conclusion: Acquired gynatresia was more common in Lagos than congenital gynatresia. The causes of acquired gynatresia are preventable and could be eliminated by health education.