The Path of Birth is Not Always Normal

Abstract

Cervical agenesis is a rare congenital Mullerian anomaly. Its association with vaginal agenesis is further rare, reported in 39% of cases of cervical agenesis. The conventional treatment for this condition was hysterectomy. However, with evolving surgical skills and assisted reproductive techniques, conservative surgery could be considered as the first-line treatment in the current era. We report one such case of cervicovaginal agenesis in a 13-year-old adolescent girl managed successfully with cervicovaginoplasty. The patient was relieved of cyclical pain abdomen and resumed menstrual cycles postoperatively.

Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

“…According to Kapczuk et al ., the age at menarche ranged from 11 to 15.6 (median, 12.2) years, and the age at repair of the malformation ranged from 11.4 to 18.2 (median, 13.1) years. [ 8 9 10 11 12 13 14 15 16 ] In contrast, urologic problems in patients with congenital renal anomalies might lead to the diagnosis of obstructed hemivagina during the prepubertal period, most frequently before the age of 5 years. [ 8 ] In a retrospective cohort study of 65 patients, 44 patients were diagnosed during the prepubertal period.…”

“…[ 8 9 10 11 12 13 14 15 16 ] In contrast, urologic problems in patients with congenital renal anomalies might lead to the diagnosis of obstructed hemivagina during the prepubertal period, most frequently before the age of 5 years. [ 8 ] In a retrospective cohort study of 65 patients, 44 patients were diagnosed during the prepubertal period. The median age at diagnosis was 8 days, and 19 patients were diagnosed during infancy.…”

“…In our systematic review, we found four patients who had spontaneous perforation of the vaginal septum that resulted in pain relief accompanied by either prolonged menstrual bleeding or purulent vaginal discharge, whereas one patient had a postpartum hemorrhage after massive vaginal rupture. [ 8 9 10 11 12 13 14 15 ] Several articles mentioned the presence of pyocolpos at the time of the diagnosis of OHVIRA syndrome. [ 20 ] Our group reported the case of a 20-year-old patient who presented with a 2-year history of primary infertility and dyspareunia;[ 21 ] in this case, vaginal examination revealed a vaginal fluctuant painful mass obliterating the right part of the vagina, and excision of the right vaginal septum drained a purulent discharge.…”

“…Among the other anomalies, Müllerian cysts may result from incomplete regression, and Mayer–Rokitansky–Küster–Hauser syndrome may be characterized by one unicornuate uterus and one rudimentary uterine horn. [ 7 8 9 ] OHVIRA presents with a partial septum leading to one unobstructed and one obstructed vagina.…”

Step-By-Step Demonstration of Laparoscopic Cervicovaginoplasty

“…In our previous article,[ 1 ] a rare case of cervicovaginal agenesis was managed by laparotomy and cervicovaginoplasty and the importance of uterine conservative surgeries over hysterectomy was discussed. Whenever feasible, a minimally invasive approach should be preferred.…”