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- Title
Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty.
- Authors
Kisku, Sundeep; Varghese, Lilly; Kekre, Aruna; Sen, Sudipta; Karl, Sampath; Mathai, John; Thomas, Reju; Barla, Ravi
- 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.
- Subjects
VAGINAL diseases; VAGINAL disease treatment; MENSTRUAL cycle; VAGINOPLASTY; RARE diseases; VAGINA abnormalities; HYSTERECTOMY; FERTILITY; PATIENTS
- Publication
Pediatric Surgery International, 2014, Vol 30, Issue 10, p1051
- ISSN
0179-0358
- Publication type
Article
- DOI
10.1007/s00383-014-3550-6