Congenital absence of the vagina with variable uterine development known as Mullerian agenesis. We presented the case of a patient with distal vagina agenesis with presence of proximal vagina and functioning unicornoate uterus. A 13-year-old patient was referred to pelvic floor service due to primary amenorrhea and pelvic pain. She was diagnosed with the distal vaginal agenesis, functional unicornoate uterus and the ectopic right kidney. Rectoabdominal examination revealed segmental vaginal agenesis and a likely atretic cervix with a huge abdominopelvic mass of about 10 cm in size. On exploratory laparotomy, the bladder was completely dilated and the right kidney was ectopic and both kidneys had moderate hydronephrosis. On the left, a unicorn uterus containing blood and clot, and on the right, a non-functional rudimentary horn with a normal fallopian tube was seen. A neovagina was created by dissection of the space between the urethra hyatus and rectum in laparatomy. It is important to note that the patient may initially present with urinary symptoms and renal signs. Therefore, in the symptoms of urinary tract obstruction, mullerian anomalies should be considered.
Objectives: In this study, radical hysterectomy, followed by neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC) was compared with radical hysterectomy in patients with early-stage cervical cancer. Material and Methods: This retrospective comparative observational study was performed on 13 patients with LACC International Federation of Gynecology and Obstetrics (FIGO) stage IB2-IIB who underwent a radical hysterectomy after NACT between March 2014 and November 2018. This group was compared with 18 patients undergoing radical hysterectomy with cervical cancer FIGO stage IIA-IB1 in the same period of time. Results: In the NACT group, 8 (61.5%) and 5 (38.4%) patients were in stages IIB and IB2, respectively, and 13 (72.2%) cases were in the IB1 stage in the non-NACT group. Post-operative blood transfusion in the NACT group was significantly higher compared to the non-NACT group [5 (38.4%) patients versus 0, P = 0.008]. The estimated blood loss (EBL) and operative time were similar between the groups. Finally, there were no significant differences in terms of intra-operative and other post-operative complications. Conclusions: Radical hysterectomy after NACT in women with LACC seems to be safe and reduces the need for radiation in patients with NACT who are at stage IIB. These results need to be confirmed in studies with a larger patient sample.
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