Primary cervico‐uterine anastomosis in a patient with agenesis of the uterine isthmus: A case report and review

Abstract

Arrested caudal extension of the fused Müllerian ducts, either complete or segmental, causes obstruction of the outflow tract. We describe a case of agenesis of the uterine isthmus and the procedure to establish the continuity of the outflow tract. A 15-year-old girl with cyclic pelvic pain and amenorrhea was found to have a 3-cm gap between the uterine body and the cervix. After cervico-uterine anastomosis via laparotomy she menstruated normally and was pain-free. Selected cases of arrested Müllerian duct extension can be corrected by primary anastomosis, which establishes anatomical continuity and restores menstruation and, possibly, future fertility.

A Rare Case Report of Isthmus Agenesis

“…We found one case report describing a similar, but not identical, uterine anomaly: a 15-year-old girl had a 3 cm gap between uterus and cervix. [3] She presented with cyclic pelvic pain and amenorrhea. After primary anastomosis using the laparoscopic and hysteroscopic approach, menstruation started, and the individual was pain-free.…”

Diagnosis and Surgical Treatment of Uterine Isthmus Atresia: A Case Report and Review of the Literature

“…To minimize the risk of stenosis, another study used a silicone stent in uterovaginal anastomosis that was kept in place for 6 months until inflammation was minimized [3]. Richards et al [10] described a similar case in 2018, in which primary cervicouterine anastomosis was performed by means of laparotomy with a Foley catheter in the cervical canal that was removed 7 days after surgery. The patient remained pain free and experienced monthly menstruation 17 months after surgery.…”