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CC BY 4.0 · Surg J (N Y) 2022; 08(04): e297-e301
DOI: 10.1055/s-0042-1757555
Case Report

Abdominoperineal Approach to Uterovaginal Anastomosis in Cervical Dysgenesis: A Case Report and Review of Literature

Ajay Halder 
1   Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Shweta Patel
1   Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
,
Pankhuri Dubey
1   Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Abstract

Genital outflow tract obstruction due to cervical agenesis is an uncommon Mullerian duct anomaly, increasingly being treated with conservative surgery by creation of an outflow tract by drilling or coring into the cervical remnant or by uterovaginal anastomosis. A 19-year-old woman with cervical dysgenesis in the present case underwent a successful uterovaginal anastomosis to relieve the obstructive menstrual symptoms and preserve the future reproductive function. The neouterovaginal canal was created over a mold of Foley's catheter by anastomosis anterior surface of the uterine corpus to the vaginal vault, bypassing the dysgenetic cervix and using the fibrous band of cervix as support. Normal cyclical menses were restored. Steps of the procedure are detailed in this case report.

Keywords

uterovaginal anastomosis - cervical dysgenesis - Mullerian anomalies - primary amenorrhea


Publication History

Received: 08 January 2022

Accepted: 29 August 2022

Article published online:
06 November 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001; 7 (02) 161-174
    CrossrefPubMedGoogle Scholar
  • 2 Rock JA, Roberts CP, Jones Jr HW. Congenital anomalies of the uterine cervix: lessons from 30 cases managed clinically by a common protocol. Fertil Steril 2010; 94 (05) 1858-1863
    CrossrefPubMedGoogle Scholar
  • 3 Bulsa M, Błogowska A, Malecha J, Uzar A, Chudecka-Głaz A, Rzepka-Górska I. Operative treatment of developmental abnormalities of sexual organs in girls [in Polish]. Ginekol Pol 1999; 70 (05) 275-278
    PubMedGoogle Scholar
  • 4 Reinhold C, Hricak H, Forstner R. et al. Primary amenorrhea: evaluation with MR imaging. Radiology 1997; 203 (02) 383-390
    CrossrefPubMedGoogle Scholar
  • 5 Lang IM, Babyn P, Oliver GD. MR imaging of paediatric uterovaginal anomalies. Pediatr Radiol 1999; 29 (03) 163-170
    CrossrefPubMedGoogle Scholar
  • 6 Letterie GS. Combined congenital absence of the vagina and cervix. Diagnosis with magnetic resonance imaging and surgical management. Gynecol Obstet Invest 1998; 46 (01) 65-67
    CrossrefPubMedGoogle Scholar
  • 7 Grimbizis GF, Gordts S, Di Spiezio Sardo A. et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod 2013; 28 (08) 2032-2044
    CrossrefPubMedGoogle Scholar
  • 8 Chakravarty B, Konar H, Chowdhury NN. Pregnancies after reconstructive surgery for congenital cervicovaginal atresia. Am J Obstet Gynecol 2000; 183 (02) 421-423
    CrossrefPubMedGoogle Scholar
  • 9 Keepanasseril A, Saha SC, Bagga R. et al. Uterovaginal anastomosis for the management of congenital atresia of the uterine cervix. Gynecol Surg 2011; 8: 161-164 https://doi.org/10.1007/s10397-010-0640
    CrossrefPubMedGoogle Scholar
  • 10 Fedele L, Bianchi S, Frontino G, Berlanda N, Montefusco S, Borruto F. Laparoscopically assisted uterovestibular anastomosis in patients with uterine cervix atresia and vaginal aplasia. Fertil Steril 2008; 89 (01) 212-216
    CrossrefPubMedGoogle Scholar
  • 11 Deffarges JV, Haddad B, Musset R, Paniel BJ. Utero-vaginal anastomosis in women with uterine cervix atresia: long-term follow-up and reproductive performance. A study of 18 cases. Hum Reprod 2001; 16 (08) 1722-1725
    CrossrefPubMedGoogle Scholar
  • 12 Kriplani A, Kachhawa G, Awasthi D, Kulshrestha V. Laparoscopic-assisted uterovaginal anastomosis in congenital atresia of uterine cervix: follow-up study. J Minim Invasive Gynecol 2012; 19 (04) 477-484
    CrossrefPubMedGoogle Scholar
  • 13 Pan HX, Luo GN, Qin CL. Laparoscopic uterovaginal anastomosis in patients with congenital cervicovaginal atresia: an institutional experience with 23 patients. Eur J Obstet Gynecol Reprod Biol 2021; 260: 218-224
    CrossrefPubMedGoogle Scholar
  • 14 Acosta-León J, Pantoja-Rojas A, Corona-Rivera JR, López-Marure E, Ploneda-Valencia CF. Cervicovaginal agenesis treated with modified Yang-Monti technique in two steps: case report and literature review. Int J Surg Case Rep 2017; 31: 176-179
    CrossrefPubMedGoogle Scholar
  • 15 Scibilia G, Pecorino B, Pagano I, Scollo P. Laparoscopic uterovaginal anastomosis for congenital isolated cervical agenesis. J Minim Invasive Gynecol 2017; 24 (04) 677-682
    CrossrefPubMedGoogle Scholar
  • 16 Zayed M, Fouad R, Elsetohy KA, Hashem AT, AbdAllah AA, Fathi AI. Uterovaginal anastomosis for cases of cryptomenorrhea due to cervical atresia with vaginal aplasia: benefits and risks. J Pediatr Adolesc Gynecol 2017; 30 (06) 641-645
    CrossrefPubMedGoogle Scholar
  • 17 Padmawar A, Syed R, Naval S. Laparoscopic uterovaginal anastomosis for cervical agenesis: a case report. J Minim Invasive Gynecol 2018; 25 (02) 334-335
    CrossrefPubMedGoogle Scholar
  • 18 Domergue S, Lange F, Fassio E, Yachouh J. Spatulated anastomosis with continuous suture in microreconstructive surgery. J Craniofac Surg 2012; 23 (04) 1140-1142
    CrossrefPubMedGoogle Scholar