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Fertil Steril. 2002 Apr;77(4):831-5.

Uterocervicoplasty with a bladder mucosa layer for the treatment of complete cervical agenesis.

Author information

  • 1Clinique et Policlinique de Chirurgie Pédiatrique, Hôpital des Enfants, Geneva, Switzerland. bugmann@hcuge.ch

Abstract

OBJECTIVE:

To create an endocervical canal in a patient with a complete cervical agenesis.

DESIGN:

Case report.

SETTING:

University hospital.

PATIENT(S):

A 12-year-old girl presented with lower abdominal pain. On examination, complete vaginal agenesis was noted, with a 2-cm vaginal dimple. A pelvic magnetic resonance imaging scan disclosed an hematometra and absence of the cervix and vagina.

INTERVENTION(S):

Initial surgical therapy consisted of a vaginoplasty with a sigmoid bowel segment and opening of the uterus by puncture and stenting. The cervical permeation failed, with immediate complete stenosis. A new attempt was made through a low sagittal hysterotomy by removing a central muscular cylinder and lining the channel with a free tubularized bladder mucosa graft. A stent was left in place.

MAIN OUTCOME MEASURE(S):

Hysteroscopy, hysterography, and clinical follow-up evaluation.

RESULT(S):

The cervical stent was removed after 5 months. A hysterography and hysteroscopy confirmed the permeability of the cervix, which was lined by a well-vascularized longitudinally folded mucosa. Regular menses had been noted for more than 3 years as of this report.

CONCLUSION(S):

Cervicoplasty with mucosal lining permits the creation of a patent cervical canal, even in the reputedly unfavorable forms of congenital cervical agenesis.

PMID:
11937142
[PubMed - indexed for MEDLINE]
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