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Management of lower vaginal agenesis in a patient with unicornuate uterus.
MedLine Citation:
PMID:  23332200     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Absence of the lower vagina occurs from abnormal development of the sinovaginal bulbs and vaginal plate.
CASE: We present a case of an adolescent girl, with a history of VACTERL and VATER status post flap vaginoplasty at 8 m of age and correction of vaginal-urethral fistula, with primary amenorrhea and cyclic pelvic pain. MRI showed a right hematocolpos. On exam the obstructed vagina was deviated to the right. Given prior urologic and rectal surgery, and laterality of unicornuate system, intra-operative ultrasonography (US) was performed. A needle was used to enter the inferior aspect of the obstructed vagina. A pull-through vaginoplasty was performed.
SUMMARY AND CONCLUSION: Vaginal pull-through is the standard treatment for lower vaginal agenesis. In a unicornuate system, the use of intra-operative US is helpful to determine the appropriate angle of dissection.
Authors:
Rebecca H Jessel; Marc R Laufer
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric and adolescent gynecology     Volume:  26     ISSN:  1873-4332     ISO Abbreviation:  J Pediatr Adolesc Gynecol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610774     Medline TA:  J Pediatr Adolesc Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e21-3     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Gynecology, Children's Hospital, Boston, MA.
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