Uterine conversing surgery in patient with cervicovaginal agenesis (A case report)

Background and Aim : Congenital absence of the vagina with variable uterine development known asmullerian agenesis or Mayer-Rokitansky-kuster-Hauser syndrome. Cervicovaginal agenesis in the presenceof normal uterus is very rare. Conservative surgery has recently been suggested in patients with congenitalcervicovaginal atresia in order to relieve the symptoms and maintain the fertility capacity.Methods : A 13 year old female referred to pelvic floor clinic, because of primary amenorrhea and severecyclic pelvic pain. Ultrasonography revealed a large amount of blood accumulation in uterine cavity andalso the cervicovaginal agenesis was reported. Both ovaries were normal. A neovagina was created bydissection of the space between bladder and rectum. Under ultrasonography guidance, two Pezzer catheterwas inserted between uterine ending and neovagina, so the catheters kept the canal patent, a soft mould wasapplied to prevent the vaginal stricture.Results : Cervicovaginal agenesis accompanied with normal functional endometrium is a rare butchallenging mullerian anomaly in case of surgical treatment. One of the successful conservative treatmentin a fully educated patient is vaginal reconstruction and uterovaginal anastomosis by stenting and continuesapplication of vaginal mould.Conclusion : Cervicovaginal agenesis accompanied with normal functional endometrium is a rare butchallenging mullerian anomaly in case of surgical treatment. One of the successful conservative treatmentin a fully educated patient is vaginal reconstruction and uterovaginal anastomosis by stenting and continuesapplication of vaginal mould.

Keywords:

vaginal agenesis , conservative treatment , pelvic pain , amenorrhea