Partial Cervical Agenesis and Complete Vaginal Atresia

Kimble, Rebecca; Molloy, G.; Sutton, Bridget M.

doi:10.1016/j.jpag.2015.11.004

Cited by 11 publications

(9 citation statements)

References 8 publications

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“…Based on the MR image, the biopsy should be performed at the leading edge of the hematometra or hematocolpos lesion, and according to the result of the pathology, the final diagnosis should be confirmed. Kimble et al [ 39 ] also stated the limitations of MRI and described the histological specimen results in their two cases of partial cervical agenesis and complete vaginal atresia. The presence of the endocervix, but absence of the ectocervix, was shown in the histological specimen after hysterectomy [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

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Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy

Kim

Nam

Lee

et al. 2021

JCM

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A retrospective cohort study of the concordance between the magnetic resonance imaging (MRI) diagnosis and final diagnosis in patients with Müllerian duct anomalies (MDAs) was conducted, and diagnostic clues were suggested. A total of 463 cases of young women who underwent pelvic MRIs from January 1995 to February 2019 at Seoul Asan Medical Center were reviewed. Interventions consisted of clinical examinations, abdominal or transvaginal/rectal ultrasound, MRI, and operative procedures, including hysteroscopy and laparoscopy. The concordance of the diagnosis between the results obtained with MRI and those obtained with surgeries was evaluated. It was found that a total of 225 cases (48.6%) showed genital tract anomalies on MRI. Among them, 105 cases (46.7%) underwent reconstructive surgery. Nineteen cases (8.4%) revealed discrepancies between the final diagnosis after surgery and the initial MRI findings and eleven cases (57.9%) had cervical anomalies. Incorrect findings associated with the MRIs were particularly evident in biopsied cases of cervical dysgenesis. A combination of physical examination, ultrasound, and MRI is suitable for preoperative work-up in the diagnoses of congenital obstructive anomalies. However, it is recommended that a pathologic confirmation of tissue at the caudal leading edge be made in obstructive genital anomalies, in cases of presumptive vaginal or cervical dysgenesis.

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Section: Discussionmentioning

confidence: 99%

“…Kimble et al [ 39 ] also stated the limitations of MRI and described the histological specimen results in their two cases of partial cervical agenesis and complete vaginal atresia. The presence of the endocervix, but absence of the ectocervix, was shown in the histological specimen after hysterectomy [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy

Kim

Nam

Lee

et al. 2021

JCM

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“…As a rare abnormality of the lower genital tract, cervical atresia with or without vaginal atresia is difficult both in diagnosis and treatment. MRI is the diagnostic gold standard . Here, we agree the decision to include all variants of cervical dysgenesis in sub‐class C4 as was made by the ESHRE/ESGE classification to avoid an extremely extensive sub‐classification, which does not seem to be user friendly.…”

Section: Discussionmentioning

confidence: 99%

Outcomes in patients undergoing robotic reconstructive uterovaginal anastomosis of congenital cervical and vaginal atresia

Zhang

Chen

Hua

2017

Robotics Computer Surgery

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ObjectiveTo introduce our experience of robotic surgery of reconstructive uterovaginal anastomosis and operative outcomes in congenital cervical and vaginal atresia patients.MethodsClinical observation and follow‐up of four patients with congenital cervical and vaginal atresia who underwent robotic reconstruction of cervix and vagina by SIS (small intestinal submucosa, SIS) graft.ResultsAverage patient age was 13.8 ± 2.2. Patients complained of severe periodic abdominal pain. Diagnosis was made according to clinical characteristics, physical examination, MRI and classified by ESHRE/ESGE system. All patients underwent reconstruction of cervix and vagina by uterovaginal anastomosis by SIS graft. Average operation time was 232.5 ± 89.2 min, average blood loss was 225.0 ± 95.7 mL. After surgery, all patients have regular menstruation without pain. Average follow up was 12 months, average vagina length was 8.9 ± 0.3 cm, average vagina width was 2.9 ± 0.1 cm.ConclusionRobotic assisted reconstruction of cervix and vagina is feasible from our experience, enlarged cases and additional studies are required.

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“…To investigate the feasibility of preserving the uterus for complete vaginal atresia, we increased the sample by literature searching. One hundred and one cases with complete vaginal atresia, who received cervicovaginal anastomosis or uterovaginal anastomosis, were identified from the literature 5 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 . The outcomes of these patients are shown in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

Clinical features of congenital complete vaginal atresia combined with cervical aplasia: A retrospective study of 19 patients and literature review

Mei

Zhang

Chen

et al. 2021

Congenital Anomalies

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Congenital vaginal atresia is a rare congenital reproductive tract abnormality. To assess the clinical manifestations and feasibility of preserving uterus for congenital complete vaginal atresia with cervical aplasia, nineteen cases who underwent surgical treatment in West China Second Hospital of Sichuan University were retrospectively studied. The cervical status, clinical manifestations, the rate of vaginal re-stenosis and pelvic inflammation after surgery were assessed. Additional 101 similar cases searched through digital Pub Med were included to analyze the feasibility of preserving the uterus. Periodic abdominal pain, primary amenorrhea, and pelvic mass were the primary signs and symptoms. According to the magnetic resonance imaging (MRI), all the uterine cavities expanded, and the atresia sites were above the inner urethral orifice. Data of the cases preserving uteri from both our hospital and the literature showed the rate of re-stenosis in patients with external cervical obstruction was 15.9% while it was 40% in the other types of cervical aplasia (P = .026). The rate of recurrent pelvic inflammation and hysterectomy was 2.3% for cervical external os obstruction and 8% for the other cervical aplasia types(P = .296). In conclusion, vaginoplasty and cervicovaginal anastomosis could preserve the fertility for complete vaginal atresia with cervical external os obstruction.

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Partial Cervical Agenesis and Complete Vaginal Atresia

Cited by 11 publications

References 8 publications

Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy

Congenital Obstructive Müllerian Anomaly: The Pitfalls of a Magnetic Resonance Imaging-Based Diagnosis and the Importance of Intraoperative Biopsy

Outcomes in patients undergoing robotic reconstructive uterovaginal anastomosis of congenital cervical and vaginal atresia

Clinical features of congenital complete vaginal atresia combined with cervical aplasia: A retrospective study of 19 patients and literature review

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