Congenital Atresia of the Uterine Cervix

Farber, Miriam B.

doi:10.1055/s-2007-1022482

Cited by 9 publications

(4 citation statements)

References 12 publications

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“…Cervical fibrous cord and absence of the vagina. There are reports of Wharton and SIS neovagina with restoration of the utero-cervix-neovagina continuity and menstruation up to 60 months (18,42). However, when adequate cervical tissues are not available, the cervicovaginal reconstruction may not have good outcomes, and hysterectomy may be necessary (6) (see Table 2).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Current knowledge about the management of congenital cervical malformations: a literature review

Mikos

Gordts²,

Grimbizis

2020

Fertility and Sterility

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The prevalence of congenital cervical agenesis or dysgenesis ranges from 1/80,000 to 1/100,000, and in about 50% of these cases it coexists with congenital vaginal agenesis. This narrative review summarizes the contemporary knowledge in the field of conservative surgical restoration of the reproductive tract. The management of congenital cervical malformations aims to [1] provide relief from the obstructive symptoms, [2] establish normal sexual function, and [3] preserve the uterus for future fertility. In cases of cervical agenesis and vaginal aplasia, the surgical approach involves the creation of neovagina, the creation of neocervix, and then subsequent restoration of the continuity of the genital tract. In cases where vagina is not congenitally absent, the surgical approach involves either a direct uterovaginal anastomosis or initial creation of neocervix and then subsequent restoration of the continuity of the genital tract. The neocervix can be surgically created with small intestinal submucosa, split-thickness skin graft, full-thickness skin graft, peritoneal flap, or vaginal mucosa lined with a polytetrafluoroethylene graft. Most of the published cases report long-term menstruation and sporadic pregnancies. Conservative surgery of cervical congenital malformations could serve as a first-line treatment. Sexual function and menstruation are established in the majority of patients. Extirpatory surgery may be preserved for surgical failures after initial restoration of the continuity of uterus-cervix-vagina or in cases with more complex anatomy. (Fertil Steril Ò 2020;113:723-32. Ó2020 by American Society for Reproductive Medicine.

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Section: Surgical Treatmentmentioning

confidence: 99%

Current knowledge about the management of congenital cervical malformations: a literature review

Mikos

Gordts²,

Grimbizis

2020

Fertility and Sterility

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“…Históricamente, la histerectomía fue considerada el tratamiento preferido (20) ; pero, posteriormente, se ha ideado procedimientos quirúrgicos orientados a formar una neovagina y tracto endocervical utilizando tanto injertos de piel como de mucosa. (21) Su beneficio es que REVISTA PERUANA DE GINECOLOGÍA Y OBSTETRICIA permite la menstruación y tiene potencial posibilidad de lograr embarazos espontáneos. (22) Los avances en endocrinología reproductiva y terapia de la fertilidad actualmente disponibles, han proporcionado a estas pacientes jóvenes la opción de recibir medicación para inducir una amenorrea iatrogénica que elimine el dolor pélvico y permita conservar su útero hasta que desee una gestación.…”

Section: Anomalías Del Desarrollounclassified

Evaluación Actualizada Y Manejo Práctico Del Factor Cervical De Infertilidad

Madera¹,

Llerena²,

Gómez³

2015

Rev peru ginecol obstet.

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El mecanismo de migración de los espermatozoides por el cuello uterino, desempeña un papel de enorme importancia en el proceso de reproducción del ser humano. Su participación en el transporte de los espermatozoides y las funciones del moco cervical (MC), son de gran relevancia en infertilidad. El factor cervical rara vez se le diagnostica como causa única de infertilidad, ya que en la mayoría de casos solo representa un obstáculo relativo. Se estima su incidencia entre 5% y 10%. Lo más frecuente es que el factor cervical sea uno de los componentes de la infertilidad de etiología multifactorial y que potencie otros factores de subfertilidad: deficiencia seminal y alteraciones ovulatorias.

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“…In more than 50% of 35 cases reported, additional anomalies of the internal genitalia were noted; 1 the most usual coexisting anomaly noted is vaginal agenesis. 1 The following report il· lustrates the important role of ultrasound in diagnosis and assisted surgical management of these cases. …”

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confidence: 99%

Ultrasonographic diagnosis and assisted surgical management of hematotrachelos and hematometra due to uterine cervical atresia with associated vaginal agenesis.

Sherer¹,

Beyth²

1989

Journal of Ultrasound in Medicine

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Congenital atresia of the cervix is a very unusual anomaly of the paramesonephric ducts. In more than 50% of 35 cases reported, additional anomalies of the internal genitalia were noted; 1 the most usual coexisting anomaly noted is vaginal agenesis. 1 The following report il· lustrates the important role of ultrasound in diagnosis and assisted surgical management of these cases. CASE REPORTA 12-year-old premenarchal female presented complaining of recurrent lower abdominal pain. Her first symptoms appeared one month prior to her current admission and persisted for a five-day period. Her past medical history was unremarkable. Physical examination revealed a healthy ado· lescent with apparent early secondary sexual features. A midline lower abdominal mas was palpated suprapubically. The external genitalia were normal. An apparently imperforate hymen was neither distended or discolored. Rectal examination disclosed a moderately tender midline 14 em mass, palpated high in the pelvis. A bidigital exam between the introitus area and the rectum ruled out hematocolpos. Laboratory tests were normal. Ultrasound examination (Dia• sonics DRF 200, 3.5-MHz sector transducer) demonstrated a mass measuring 13 X 6 X5 em. The longitudinal scan revealed an hourglass structure (Fig. 1); the specific anatomy of the inferior aspect of which was depicted separately (Fig. 2). The transverse scan revealed a distended uterus with normal ovaries (Fig. 3); a lower transverse scan revealed the distended cervix (Fig. 4). An intravenous pyelogram demonstrated two normal kidneys and evidence of a mass lying against the bladder. The above findings were compatible with hematotra· chelos and hematometra. Due to the above diagnosis and per· sisting pelvic pain, further examination and therapeutic measures were undertaken. On examination under general anesthesia, no evidence of an existing vagina was found. With continuous ultrasound guidance, a 16-gauge needle was introduced transperineally between the urethra and the rectum. The lower aspect of the above mass was probed and aspiration of dark blood confirmed the diagnosis of an obstructed upper genital tract. At this stage, a large Stamey catheter was inserted along the same tract and 300 ml of dark old menstrual blood removed with negative pressure. Simultaneous ultrasound scanning demonstrated concomitant contraction of the uterine and cervical walls. The catheter was left in situ with the hope that an epithelialized tract would result. Prophylactic antibi· otic treatment was initiated and continued for 5 days. During the postoperative course, a hysterosalpingogram through the indwelling catheter demonstrated a normal-shaped uterus with patent fallopian tubes. The patient was discharged on the fifth postoperative day without complications. The catheter remained positioned for 3 months, during which time three asymptomatic periods occurred with apparent good drainage. Ultrasonographic follow-up during this period did not reveal

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Congenital Atresia of the Uterine Cervix

Cited by 9 publications

References 12 publications

Current knowledge about the management of congenital cervical malformations: a literature review

Current knowledge about the management of congenital cervical malformations: a literature review

Evaluación Actualizada Y Manejo Práctico Del Factor Cervical De Infertilidad

Ultrasonographic diagnosis and assisted surgical management of hematotrachelos and hematometra due to uterine cervical atresia with associated vaginal agenesis.

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