Abstract
Objective: To describe a unique vaginal outlet obstruction and its ultrasound-assisted surgical correction. Design: Case report. Setting: An academic medical center. Patient(s): A 12-year-old girl was seen with cyclic abdominal pain, nausea, and an abdominal mass. External genital examination revealed no vaginal opening or dimple. Transabdominal ultrasound revealed a large hematometrocolpos 5 cm proximal to the perineum, with an otherwise normal-appearing uterus and ovaries. Intervention(s): Surgical treatment included perineal incision, creation of a 5-cm passage through connective tissue, drainage of the hematometrocolpos, and mobilization of the proximal vagina, allowing for pull-through vaginoplasty. Ultrasound guidance was used throughout the surgery and allowed for a safe transperineal approach. A vaginal form was placed in the neovagina. Main Outcome Measure(s): Follow-up clinical evaluation and pelvic ultrasonography. Result(s): A well-healed perineum and patent 5-cm-long vagina were observed at 4-month follow-up. The patient reported three regular menses. Postoperative pelvic ultrasound scan was normal. Conclusion(s): We describe a unique case of isolated distal vaginal agenesis of significant length that was successfully treated via a perineal approach with the intra-operative assistance of ultrasound guidance.
Original language | English (US) |
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Pages (from-to) | 976.e9-976.e12 |
Journal | Fertility and sterility |
Volume | 87 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2007 |
Externally published | Yes |
Keywords
- Vaginal agenesis
- hematometrocolpos
- ultrasound guidance
ASJC Scopus subject areas
- Reproductive Medicine
- Obstetrics and Gynecology