Laparoscopic neo-os creation in an adolescent with uterus didelphys and obstructed hemivagina

Patterson, Danielle; Mueller, Catherine; Strubel, Naomi; Rivera, Rafael; Ginsburg, Howard B.; Nadler, Evan P.

doi:10.1016/j.jpedsurg.2006.06.026

Cited by 11 publications

(14 citation statements)

References 15 publications

(24 reference statements)

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“…Typically, patients with an obstructing Müllerian anomaly present after menarche, with dysmenorrhea, severe pelvic or abdominal pain, or the presence of a pelvic or intraabdominal mass [3,11,12]. Other signs and symptoms vary depending on the individual patient's uterovaginal anatomy and may include fever, signs of intra-abdominal infection or purulent vaginal discharge (due to pyocolpos), urinary incontinence, and dyspareunia [1,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Resection of the obstructive vaginal septum with marsupialization of the margins is the established treatment of didelphic uterus with blind hemivagina since drainage alone may lead to spontaneous closure and subsequent reformation of hemato-or pyocolpos [3,8,11]. This procedure allows evacuation of the sequestered material and preserves reproductive potential [8].…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, the addition of laparoscopy allows for complete assessment of the uterine malformation as well as for associated complications affecting future fertility. It also allows for diagnosis of severe adnexal complications that may necessitate salpingectomy or hemi hysterectomy [11].…”

Section: Discussionmentioning

confidence: 99%

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A case of didelphic uterus and blind hemivagina with renal dysplasia and ectopic ureter presenting with vulvodynia and recurrent fever

et al. 2009

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Didelphic uterus with blind hemivagina and ipsilateral renal anomaly is a rare congenital malformation. The pathogenesis of this syndrome and its embryologic origin are still the subject of discussion. Due to the variable clinical picture and low index of suspicion, diagnosis is often delayed or inaccurate. Conservative surgical treatmentexcision of the obstructing vaginal septum and marsupialization of the blind hemivagina-is considered the most appropriate treatment. This report describes the case of a 16-year-old girl with didelphic uterus and double vagina, with obstruction of the left hemivagina. The patient was also diagnosed with left renal dysplasia and ipsilateral ureter communication with the obstructed vagina. Following various examinations and left uretero-nephrectomy, the patient was effectively treated with resection of the vaginal septum.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of didelphic uterus and blind hemivagina with renal dysplasia and ectopic ureter presenting with vulvodynia and recurrent fever

et al. 2009

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“…Nowadays, endoscopic techniques (laparoscopy and hysteroscopy) should be kept mainly for the patient’s treatment or for the elucidation of extremely rare and unclassified cases [139]. …”

Section: Imaging Techniques For the Diagnosis Of Uterine Anomaliesmentioning

confidence: 99%

Clinical approach for the classification of congenital uterine malformations

Grimbizis

Campo

2012

Gynecol Surg

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A more objective, accurate and non-invasive estimation of uterine morphology is nowadays feasible based on the use of modern imaging techniques. The validity of the current classification systems in effective categorization of the female genital malformations has been already challenged. A new clinical approach for the classification of uterine anomalies is proposed. Deviation from normal uterine anatomy is the basic characteristic used in analogy to the American Fertility Society classification. The embryological origin of the anomalies is used as a secondary parameter. Uterine anomalies are classified into the following classes: 0, normal uterus; I, dysmorphic uterus; II, septate uterus (absorption defect); III, dysfused uterus (fusion defect); IV, unilateral formed uterus (formation defect); V, aplastic or dysplastic uterus (formation defect); VI, for still unclassified cases. A subdivision of these main classes to further anatomical varieties with clinical significance is also presented. The new proposal has been designed taking into account the experience gained from the use of the currently available classification systems and intending to be as simple as possible, clear enough and accurate as well as open for further development. This proposal could be used as a starting point for a working group of experts in the field.

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“…Some surgeons encourage specific operative techniques, such as a “Z”-plasty, as well as pre- and/or postoperative vaginal dilation to reduce contracture or stenosis risks (8, 9). More recently, some have even suggested use of a vaginal mold secured to an elastic belt, used while sleeping, or a Penrose drain (10, 11). Dilation or specific operative techniques become more difficult in the situation of small or high hemivaginal septae.…”

Section: Introductionmentioning

confidence: 99%

Novel use of a tracheobronchial stent in a patient with uterine didelphys and obstructed hemivagina

Cooper

Merritt

2010

Fertility and Sterility

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Objective: To describe a novel use for a tracheobronchial stent to maintain patency after vaginal septum excision in a patient with an obstructed hemivagina and uterine didelphys. Design: Description of a novel technique Setting: University-affiliated Children’s Hospital Patient: One patient with an obstructed hemivagina and uterine didelphys who presented with hematometria and hematocolpos. Intervention: In order to maintain patency and decrease stenosis risk after vaginal septum excision, a coated tracheobronchial stent was deployed and left in place for 6 weeks. Main Outcome Measure: To evaluate ease of stent placement and removal, re-epithelialization and patency of the neo-vagina, and post-operative assessment of pain and recurrent obstruction. Results: The tracheobroncheal stent was easily positioned and deployed with vaginoscopic guidance. Six weeks later it was removed without any tissue in-growth or granulation tissue noted. The vaginal walls were nicely epithelialized. Twelve months post-operatively the patient remained pain free with regular cycles and no evidence of obstruction or abnormality on ultrasound. Conclusion: Use of a coated tracheobronchial stent to maintain patency after septum excision in a patient with an obstructed hemivagina presents a safe, easy and effective option to diminish stenosis risk and avoid infectious complications or hysterectomy.

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Laparoscopic neo-os creation in an adolescent with uterus didelphys and obstructed hemivagina

Cited by 11 publications

References 15 publications

A case of didelphic uterus and blind hemivagina with renal dysplasia and ectopic ureter presenting with vulvodynia and recurrent fever

A case of didelphic uterus and blind hemivagina with renal dysplasia and ectopic ureter presenting with vulvodynia and recurrent fever

Clinical approach for the classification of congenital uterine malformations

Novel use of a tracheobronchial stent in a patient with uterine didelphys and obstructed hemivagina

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