Clinical features and surgical procedures of congenital vaginal atresia—A retrospective study of 67 patients

Xie, Zhihong; Zhang, Xiaoping; Zhang, Ningzhi; Xiao, Hong; Liu, Yongying; Liu, Jiandong; Chen, Lili; Li, Liang; Zhang, Linlin; Zhang, Youguo

doi:10.1016/j.ejogrb.2017.08.016

Cited by 10 publications

(8 citation statements)

References 10 publications

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“…The 9 enrolled patients had a median (IQR) age of 15.0 (14.0-18.0) years, a median (IQR) uterus size of 54.0 (33.0-84.7) cm 3 , and a median (IQR) duration of abdominal pain of 12.0 (1.6-42.0) months. Among the patients, 5/9 presented with pelvic adhesions.…”

Section: Patient Featuresmentioning

confidence: 99%

“…Congenital vaginal atresia is a rare malformation of the female reproductive tract, which can be divided into partial and complete vaginal atresia ( 1 , 2 ). Congenital vaginal atresia can obstruct menstrual blood flow and can also lead to a series of clinical problems, such as amenorrhea, abdominal pain, pelvic mass, and endometriosis, which require timely surgical dissociation to relieve the obstruction ( 3 , 4 ). Complete vaginal atresia is usually associated with cervical dysplasia or cervical atresia ( 5 - 7 ).…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

Liu¹,

Zhang²,

Wang³

et al. 2023

Ann Transl Med

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Background: Hysterectomy places a huge physical and mental burden on young female patients with congenital cervical and complete vaginal atresia. Thus, it is necessary to develop a method to detach the obstruction and simultaneously preserve the vagina and uterus in these patients. This study sought to evaluate the efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia.Methods: Between April 2013 and June 2022, 9 patients with congenital cervical and complete vaginal atresia at Henan Provincial People's Hospital were enrolled in this prospective study. All the patients were treated with laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty. Baseline clinical features (such as age, uterus size, etc.) were collected. The surgical success rate and adverse events were assessed. Results:The 9 enrolled patients had a median [interquartile range (IQR)] age of 15.0 (14.0-18.0) years, and 5/9 patients presented with pelvic adhesions. The surgeries were successful in all (9/9) patients, who preserved their vagina and uterus with a normal menstrual cycle. After a median follow-up duration of 48 months, the neovagina had a median length of 7.5 cm. Post-surgical complications occurred in 3/9 patients, which were cured by an appropriate treatment. The 5/9 married patients reported being satisfied with their sexual life.Conclusions: Even though the current study preliminary exhibits the efficiency of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia, due to the small sample size, lack of a control group, and relatively high incidence of the adverse events, further studies are still needed to verify the current findings. The current study put forward a further direction for preserving the vagina and uterus simultaneously for those patients with congenital cervical and complete vaginal atresia.

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Section: Patient Featuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

Liu¹,

Zhang²,

Wang³

et al. 2023

Ann Transl Med

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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%

“…feasible for patients with cervical external os obstruction.Gynecologists [8][9][10][11][12]15,16,20,21 tried to preserve uterus and fertility for the patients with complete cervical atresia or cervical fibrous cord, but the sample size was small. More high quality clinical controlled trials with longer follow-up are needed for further assessment.…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, the cases with a short or long solid cervix should receive hysterectomy and vaginoplasty, which is somewhat consistent with our result. Considering most of the included studies were case reports with relatively higher publication bias, it is speculated that uterus preservation may be feasible for patients with cervical external os obstruction.Gynecologists 8 , 9 , 10 , 11 , 12 , 15 , 16 , 20 , 21 tried to preserve uterus and fertility for the patients with complete cervical atresia or cervical fibrous cord, but the sample size was small. More high quality clinical controlled trials with longer follow‐up are needed for further assessment.…”

Section: Discussionmentioning

confidence: 99%

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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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Modified balloon vaginoplasty for high position vaginal atresia

Zhang

et al. 2022

Pediatr Surg Int

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Clinical features and surgical procedures of congenital vaginal atresia—A retrospective study of 67 patients

Cited by 10 publications

References 10 publications

Efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

Efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

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

Modified balloon vaginoplasty for high position vaginal atresia

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