Agenesis Serviks

Abstract

AbstrakLatar Belakang : Agenesis serviks merupakan suatu kelainan kongenital sistem reproduksi wanita yang sangat jarang terjadi dengan manifestasi berupa tidak terbentuknya serviks uteri dengan perkembangan uterus serta tanda-tanda seks sekunder yang normal. Berdasarkan American Fertility Society, agenesis serviks dikelompokkan dalam anomali Müllerian tipe IB. Gejala yang muncul berupa amenorea primer, nyeri perut bawah siklik dan infertilitas. Tujuan : Melaporkan penanganan kasus agenesis serviks. Laporan Kasus : Dilaporkan seorang perempuan, 28 tahun, datang dengan keluhan amenorea primer, nyeri perut bawah siklik dan infertilitas primer 3 tahun. Dari pemeriksaan inspekulo dan ultrasonografi transvaginal didapatkan kesan uterus yang sedikit lebih kecil dari normal, tanpa serviks uteri, disertai perlengketan, kedua ovarium normal. Dilakukan laparoskopi anastomosis utero-vagina dengan pemasangan kondom kateter yang dipertahankan selama 3 bulan. Dua minggu setelah kateter dilepaskan, dilakukan histeroskopi, didapatkan saluran yang dibuat menutup kembali. Kesimpulan : Pada kasus ini, setelah dilakukan laparoskopi anastomosis utero-vagina didapatkan saluran yang dibuat menutup kembali sehingga perlu dilakukan evaluasi yang lebih mendalam untuk mendapatkan hasil yang lebih efektif. Kata Kunci : Anomali Müllerian tipe IB, agenesis serviks, amenorea primer, infertilitas, laparoskopi anastomosis utero-vagina Abstract Background : Cervical agenesis is an extremely rare congenital anomaly of female reproductive system with manifestation of the absence of uterine cervix with normal development of uterine and secondary sex signs. According to the American Fertility Society, cervical agenesis is classified as type IB Müllerian anomaly. Symptoms are include primary amenorrhea, cyclic abdominal lower pain and infertility. Objective : To report the management of cervical agenesis. Case Report : Reportedly, a woman, 28 years old, came with complaints of primary amenorrhea, cyclic abdominal lower pain and 3 years of primary infertility. From speculum and transvaginal ultrasonography examination, the uterine is slightly smaller than normal, without cervical uterine, found adhesion, both ovarian were normal. Laparoscopic utero-vaginal anastomosis was performed and catheter condom was maintained in the cervical canal for 3 months. Two weeks after catheter was removed, a hysteroscopy was performed, but the canal was found closed. Conclusion : In this case, after the laparoscopic utero-vaginal anastomosis was performed, the cervical canal which has been made, was found closed. So, the further evaluation is needed to get more effective results.