Ultrasound-assisted repair of a unique case of distal vaginal agenesis

Jessica Kresowik, Ginny L. Ryan, J. Christopher Austin, Bradley J. Van Voorhis

Research output: Contribution to journalArticle

10 Scopus citations

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 languageEnglish (US)
Pages (from-to)976.e9-976.e12
JournalFertility and sterility
Volume87
Issue number4
DOIs
StatePublished - Apr 2007

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Keywords

  • Vaginal agenesis
  • hematometrocolpos
  • ultrasound guidance

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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