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

Abstract

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.

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

“…Complete vaginal atresia is commonly concurrent with cervical dysplasia or cervical atresia ( 3 , 7 ). Patients with complete vaginal atresia always suffer from abdominal pain, fallopian tube dilation, cyst formation, and pelvic endometriosis due to the hematocele in the uterine or cervical duct and the reflux of menstrual blood into the pelvic cavity ( 5 , 17 ).…”

“…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)(6)(7). Currently, the main surgical method for patients with complete vaginal atresia is vaginoplasty with or without sparing the uterus (8,9).…”

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

“…Complete vaginal atresia is commonly accompanied by cervical dysplasia or cervical atresia ( 1 , 13 ). Patients with complete vaginal atresia consistently experience abdominal pain, fallopian tube dilation, cyst formation, and pelvic endometriosis due to hematocele in the uterine or cervical duct and the reflux of menstrual blood into the pelvic cavity ( 3 , 14 ).…”

“…Congenital vaginal atresia is a rare malformation of the female reproductive tract that can be classified into partial and complete vaginal atresia ( 1 ). Congenital vaginal atresia can obstruct menstrual blood flow and may 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 ( 2 ).…”

“…Congenital vaginal atresia can obstruct menstrual blood flow and may 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 ( 2 ). Complete vaginal atresia is usually associated with cervical dysplasia or cervical atresia ( 1 , 3 , 4 ). Currently, the main surgical method for patients with complete vaginal atresia is vaginoplasty with or without sparing of the uterus ( 5 , 6 ).…”