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Federación Mexicana de Ginecología y Obstetricia, A.C.

2022, Number 10

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Ginecol Obstet Mex 2022; 90 (10)

Cervical reconstruction with vaginal conexion secundary to cervical agenesia. Case report

López-Rivadeneyra E, Malfavón-Farías M, Vázquez-Camacho EE, Tovilla-Mercado JM, Halffter-Mijares A

Language: Spanish
References: 19
Page: 856-863
PDF size: 260.56 Kb.


ABSTRACT

Background: Congenital cervical agenesis is a rare anomaly of the Müllerian system, usually recognized during menarche. Until recently, the treatment of first choice was hysterectomy, because it was not considered a disease compatible with fertility. Today, thanks to assisted reproductive techniques, less aggressive surgical procedures have been developed that do preserve the fertility of patients.
Objective: To review a case of cervical agenesis from its surgical treatment and follow-up cervical reconstruction with the connection between the vagina and the uterus, review the literature and how to establish the long-term prognosis.
Clinical case: A 12 years old female patient was brought for consultation due to absence of menstruation. The diagnostic procedure was carried out without finding any alterations; however, in the operative diagnostic laparoscopy performed at the age of 14, indicated by cyclic pelvic pain, the absence of the cervix, a hematometra and hemiendometriosis grade IV were noticed. In the second surgery, performed in conjunction with the pediatric surgeon, the communication between the uterus and the vagina was performed by laparotomy. At present, the patient is 19 years old and her menses are cyclical, not painful. In the last ultrasound the connection between the uterus and the vagina was visualized.
Conclusions: Today, utero-vaginal anastomosis is a procedure capable of maintaining the function of the uterus and allowing pregnancy, with proper care.


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