Surgical disorders in pediatric and adolescent gynecology: Vaginal and uterine anomalies

Abstract

Obstructive vaginal and uterine anomalies including imperforate hymen, transverse vaginal septum, and vaginal and/or cervical atresia or aplasia, might rarely present in infancy or childhood with hydrocolpos and/or hydrometra but they usually go unrecognized until presentation with amenorrhea and hematocolpos and/or hematometra in puberty. They should always be included in the differential diagnosis of a suprapubic and/or introital mass; in the latter case, vaginal vascular malformations and vaginal tumors should also be considered. Uterovaginal aplasia typically manifests with amenorrhea in puberty and needs to be differentiated from complete androgen insensitivity syndrome and gonadal dysgenesis of genetic males. Uterine fusion anomalies usually present with fertility and/or obstetrical complications in adulthood. However, a unicornuate uterus with a blind rudimentary contralateral horn containing functioning endometrium, and didelphys or septate uterus with a deviating obstructive septum might present in childhood or puberty with sequelae related with secretions or menstrual retention. This review provides a collective account of the most clinically important information about vaginal and uterine anomalies in childhood and adolescence for clinicians involved in the care of young females with the aim to provide guidance in appropriate evaluation and management.

Conception following successful repair of two previous failed attempts at repair of partial transverse vaginal septum diagnosed after marital union: A case report

“…This could avoid a subsequent complication and a multiple repeat operation, as was encountered in our case. 19,20 To the best of our knowledge, we have not found any report in the literature of a shortest vaginoplasty-conception interval following successful repair of partial transverse vaginal septum, after multiple failed repair attempts. In a previous case report by Sohail et al on successful pregnancy following after transverse vaginal septum resection, the conception occurred 7 months following repair, and coitus was said to have resumed 3 months after surgery.…”

“…This could avoid a subsequent complication and a multiple repeat operation, as was encountered in our case. 19 , 20 …”

How Often Do We Discover an Abnormality of The Uterus at Delivery? Single Center Experience

“…Stagnation or maldevelopment at any stage of embryonic development leads to heterogeneous and complex anomalies of the congenital genital tract. Congenital anomalies leading to obstruction of menstrual flow include, in particular, an imperfore hymen, a transverse vaginal septum, partial agenesis of the vagina and agenesis of the cervix (10). An obstructive anomaly is manifested by primary amenorrhea and cyclic pain due to the formation of hematocolpos and hematometra.…”