Published in:
01-01-2015 | General Gynecology
An atresia cervix removal, lower uterine segment substitute for cervix and uterovaginal anastomosis: a case report and literature review
Published in: Archives of Gynecology and Obstetrics | Issue 1/2015
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Purpose
The management of cervical dysgenesis is still a big challenge, mostly due to the complexity of the malformation and the difficulty to conserve the patient’s fertility during the surgery. The objective of this article is to report a new successful approach for treating cervical dysgenesis as well as conserving patients’ fertility.
Materials and methods
We presented a case of a 22-year-old girl with vaginal agenesis and cervical dysgenesis, who after an initial failure at reconstructive surgery was successfully treated by removing a cord-like cervix and a central muscular cylinder of her lower uterine segment and lining the channel with peritoneum as the reconstructed cervix.
Results
The patient has had normal menstruation without dysmenorrhea for one and a half years since the surgery.
Conclusions
Several steps should be followed in managing patients with congenital cervical atresia: (1) a sufficient imaging evaluation before operation is necessary; (2) a falling-off-proof cervical catheter such as a mushroom catheter (also referred to as pezzers self-retaining catheter), and a proper vaginoplasty are key to a successful cervical canalization; (3) smooth grafted tissues such as peritoneum can be used to line the cervical canal to avoid adhesions.