The Department of Pediatric and Adolescent Gynecology of the Children's Rehabilitation Clinic provided complex treatment for a 13-year-old girl with a rare abnormality of the reproductive system.
The patient presented with complaints of recurrent severe pain in the lower abdomen. Based on the results of the examination, she was diagnosed with a congenital absence of the cervix and vagina in the presence of a well-developed uterus. This is an extremely rare abnormality and the literature describes only a few cases of surgical treatment with successful preservation of the menstruating uterus.
Photo 1. Pelvic MRI: MR signs of cervical and vaginal agenesis. Step 1: creation of a utero-neovaginal anastomosis (arrows show the tube drainage). Photo 2. Pelvic ultrasound. Step 2: insertion of a T-shaped IUD Yunona Bio-T Ag
Specialists of the Research Laboratory of Operative Gynecology and the Department of Pediatric and Adolescent Gynecology developed a tactic to treat the abnormality taking into account its characteristics in this patient.
The first stages included menstrual suppression by medication and preparation of tissues for reconstruction. Only after that it became possible to perform surgery, which consisted of creating a neovagina and utero-neovaginal anastomosis.
Result of IUD placement
The rehabilitation period was no less important. It consisted of repeated replacements of uterine-neovaginal drainage, placement of a copper-containing T-shaped IUD, preventive courses of antibiotics, care of the utero-neovaginal anastomosis as well as continued hormonal therapy to suppress menstruation for the period of treatment. Psychological support was provided to the girl at all stages.
Despite the complexity of the treatment, it is safe to say that the patient has the prerequisites for possible childbearing.
The whole team of doctors took part in the treatment of the patient: Director of the Clinic Eduard Komlichenko, Head of the Department of Pediatric and Adolescent Gynecology Nadezhda Kokhreidze, Head of the Research Laboratory for Pediatric Surgery of Congenital Anomalies Ilya Kagantsov, gynecologists Oksana Dudar and Kyaniz Alieva.