Uterine Preservation and Vaginal Reconstruction in a Patient with Congenital Vaginal Agenesis Presenting With Cyclic Menouria

Erman-Akar M., ÖZKAN Ö., ÖZKAN Ö., Yucel S., Dolay K., ERTUĞRUL F., ...Daha Fazla

JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY, cilt.18, sa.5, ss.682-685, 2011 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Sayı: 5
  • Basım Tarihi: 2011
  • Doi Numarası: 10.1016/j.jmig.2011.06.013
  • Dergi Adı: JOURNAL OF MINIMALLY INVASIVE GYNECOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.682-685
  • Anahtar Kelimeler: Menouria, Primary amenorrhea, Vesicouterine fistula, FISTULA, VESICOUTERINE, PREGNANCY
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Herein we report the case of a patient with primary amenorrhea and cyclic menouria. The patient was a 20-year-old woman with primary amenorrhea and inability to achieve sexual intercourse. Clinical examination revealed normally developed labia majora and minora, clitoris, and external urethral orifice, but no vaginal opening. A mature female pubic hair pattern was present, and axillary hair development was normal. Breasts were normally developed. Abdominopelvic magnetic resonance imaging demonstrated a remnant upper vagina and unicornuate uterus filled with fluid, and left-sided renal agenesis. Intra-operatively, a congenital vesicouterine fistulous tract was observed. The fistulous tract was completely resected. Vaginal reconstruction using a sigmoid colon pedicled flap was performed. The proximal part of the neovagina was connected to the remnant cervix, and a Foley catheter was left in the uterine cavity for 7 days to prevent obstruction. The patient has been menstruating regularly since the operation. Menouria might be an early sign of congenital vesicouterine fistula. Resection of the fistulous tract with uterine preservation might be considered in patients with vaginal agenesis. Journal of Minimally Invasive Gynecology (2011) 18, 682-685 (C) 2011 AAGL. All rights reserved.
Abstract

Herein we report the case of a patient with primary amenorrhea and cyclic menouria. The patient was a 20-year-old woman with primary amenorrhea and inability to achieve sexual intercourse. Clinical examination revealed normally developed labia majora and minora, clitoris, and external urethral orifice, but no vaginal opening. A mature female pubic hair pattern was present, and axillary hair development was normal. Breasts were normally developed. Abdominopelvic magnetic resonance imaging demonstrated a remnant upper vagina and unicornuate uterus filled with fluid, and left-sided renal agenesis. Intra-operatively, a congenital vesicouterine fistulous tract was observed. The fistulous tract was completely resected. Vaginal reconstruction using a sigmoid colon pedicled flap was performed. The proximal part of the neovagina was connected to the remnant cervix, and a Foley catheter was left in the uterine cavity for 7 days to prevent obstruction. The patient has been menstruating regularly since the operation. Menouria might be an early sign of congenital vesicouterine fistula. Resection of the fistulous tract with uterine preservation might be considered in patients with vaginal agenesis. Journal of Minimally Invasive Gynecology (2011) 18, 682-685 (C) 2011 AAGL. All rights reserved.