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CC BY 4.0 · Surg J (N Y) 2020; 06(01): e28-e32
DOI: 10.1055/s-0040-1701213
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Novel Method of Cervicoplasty Using Autologous Peritoneum for Cervicovaginal Atresia

Kazunari Fujino
1   Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
,
Yuko Ikemoto
1   Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
,
Mari Kitade
1   Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
,
Satoru Takeda
1   Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
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Publikationsverlauf

09. Juni 2019

28. Oktober 2019

Publikationsdatum:
11. Februar 2020 (online)

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Abstract

Cervicovaginal atresia with a functional uterus is rare. There are no established surgical methods to treat this condition, and only a few reports have been published on surgical techniques. Furthermore, postoperative complications, such as restenosis, often require reoperation. A 19-year-old woman was pointed out cervical hypoplasia and referred to our hospital for further examination and treatment. A pelvic examination revealed that the vagina had a slight recession with a blind end. Transrectal ultrasound and pelvic magnetic resonance imaging revealed congenital vaginal agenesis and cervical hypoplasia. Elective surgery was performed after reshaping the vagina. A radical surgery was performed 10 months later after sufficient self-dilation by using Frank's technique in an outpatient setting. At first, we approached by laparoscopically to correct autologous peritoneum and to bladder detach, then the cervical canal was identified. Next, a skin biopsy punch was used several times to hollow out the cervical tissue to shape and expand the cervical canal. A catheter was then placed in the uterus and autologous peritoneum was wrapped around it and fixed to the cervical canal. The catheter was removed 6 weeks postoperatively, and the patient continued dilating her vagina until she was able to have sexual intercourse, and then stopped the self-dilation. Eight months postoperatively, the patient did not report any menstrual irregularities. It is important to make corrections to prevent restenosis of the vagina and cervical canal and prevent the symptoms from recurring. Make use of autologous peritoneum as graft onto the cervical canal is effective method for the treatment of cervicovaginal atresia.

Keywords

cervicovaginal atresia - cervical hypoplasia - vaginal agenesis - uterovaginal anastomosis - vaginoplasty - autologous peritoneum - laparoscopic surgery
 

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