Uterovaginal anastomosis for the management of congenital atresia of the uterine cervix

Keepanasseril, Anish; Saha, Sushanta; Bagga, Rashmi; Vyas, Sameer; Dhaliwal, Lakhbir Kaur

doi:10.1007/s10397-010-0640-x

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…3 When cervical reconstruction is not feasible, uterovaginal anastomosis is preferred and recently being recommended over other alternatives as the first treatment option, as it has a lower risk of restenosis, and successful reproductive outcomes have been reported with fewer complications. 9 10 The earliest series on uterovaginal anastomosis technique described by Deffarges et al 11 reported successful creation of outflow channel in 18 patients with failure due to restenosis in only 1 woman. They also reported six spontaneous conceptions in four of these women who delivered between 36 and 38 weeks' gestation via cesarean section.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, many successful open and laparoscopic approaches to uterovestibular anastomosis for cervicovaginal aplasia have been reported with good functional and reproductive outcomes. 9 10 12 13 14 15 16 17 Interestingly, mucinous secretions such as normal endocervical gland secretions have been noted during follow-up in patients, suggesting metaplasia of the most caudal endometrial glands in the neouterovaginal channel. 10 This possibly explains fewer rates of ascending upper genital tract infections reported in patients who undergo uterovaginal anastomosis.…”

Section: Discussionmentioning

confidence: 99%

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Abdominoperineal Approach to Uterovaginal Anastomosis in Cervical Dysgenesis: A Case Report and Review of Literature

2022

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Genital outflow tract obstruction due to cervical agenesis is an uncommon Mullerian duct anomaly, increasingly being treated with conservative surgery by creation of an outflow tract by drilling or coring into the cervical remnant or by uterovaginal anastomosis. A 19-year-old woman with cervical dysgenesis in the present case underwent a successful uterovaginal anastomosis to relieve the obstructive menstrual symptoms and preserve the future reproductive function. The neouterovaginal canal was created over a mold of Foley's catheter by anastomosis anterior surface of the uterine corpus to the vaginal vault, bypassing the dysgenetic cervix and using the fibrous band of cervix as support. Normal cyclical menses were restored. Steps of the procedure are detailed in this case report.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Abdominoperineal Approach to Uterovaginal Anastomosis in Cervical Dysgenesis: A Case Report and Review of Literature

2022

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Functional and Reproductive Outcomes Following Surgical Management of Congenital Anomalies of the Cervix: A Systematic Review

Mikos

Lantzanaki

Anthoulakis

et al. 2021

Journal of Minimally Invasive Gynecology

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The purpose of this systematic review was to evaluate surgical treatment for malformations of the cervix in terms of short-and long-term postoperative function and relevant reproductive outcomes. Data Sources: International Prospective Register of Systematic Reviews (ID No CRD42019128899). Electronic databases were searched for eligible studies up to October 2019 on Medline/PubMed (1966−2019), Scopus/Elsevier (1950−2019), and Google Scholar (up to 2019. Search terms included "congenital cervical malformations/anomalies," "uterocervical aplasia/dysgenesis/agenesis," "cervical aplasia/dysgenesis/ agenesis," "m€ ullerian anomalies/dysgenesis/agenesis," "uterovaginal anastomosis," "cervical reconstruction," "uterocervical reconstruction/canalization," "cervical canalization," "reproductive/pregnancy/functional outcome," "menstruation," "pregnancy," and "regular periods." Methods of Study Selection: Studies were chosen and included with clear description of preoperative diagnosis via sonography, magnetic resonance imaging, and surgical confirmation; assessment and clear description of gynecologic anatomy and any concomitant anomalies; meticulous description of the operative technique; follow-up of at least 6 weeks postoperatively; and postoperative end points including menstrual and reproductive outcomes. We included randomized controlled trials, case-control studies (both prospective and retrospective), and case reports. Data registries, studies without clearly described primary or secondary outcomes, and studies not in the English language were excluded from the analyses. Tabulation, Integration, and Results: The literature search returned 745 studies; 546 records were initially excluded (397 not related to the topic, 15 not related to humans, 134 non-English language); 111 full-text articles were further excluded (patients underwent hysterectomy or no surgery); 88 studies with a total of 249 patients were suitable for analysis. Almost all patients had preoperative amenorrhea (248/249, 99.6%). Postoperatively, of 249 patients, resolution of menstruation occurred in 228 patients (91.6%), and hysterectomy was performed in 22 patients (8.8%); overall, there were 30 (12.0%) conceptions that resulted in 27 (10.8%) viable and 24 (9.6%) term pregnancies. Indications for hysterectomy were stenosis of the genital tract and sepsis. Coexisting vaginal agenesis and use of full thickness skin graft for creation of neocervix was associated with negative surgical outcomes. Conclusion: This review suggests that conservative surgical approaches result in better clinical and reproductive outcomes than more aggressive reconstructive surgeries for patients with malformations of the cervix.

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Functioning left uterine horn with cervico-vaginal atresia and ovarian maldescent – an unclassified Müllerian anomaly treated with horn-vaginal anastomosis

Bagga

Muthyala

Saha

et al. 2018

Journal of Obstetrics and Gynaecology

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Uterovaginal anastomosis for the management of congenital atresia of the uterine cervix

Cited by 4 publications

References 19 publications

Abdominoperineal Approach to Uterovaginal Anastomosis in Cervical Dysgenesis: A Case Report and Review of Literature

Abdominoperineal Approach to Uterovaginal Anastomosis in Cervical Dysgenesis: A Case Report and Review of Literature

Functional and Reproductive Outcomes Following Surgical Management of Congenital Anomalies of the Cervix: A Systematic Review

Functioning left uterine horn with cervico-vaginal atresia and ovarian maldescent – an unclassified Müllerian anomaly treated with horn-vaginal anastomosis

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