ABSTRACT
Background
The surgical treatment of girls with cervical atresia and complete absence of the
vagina remains a problem because of the rarity of cases and the controversial study
results.
Objective
To describe the surgical technique and long-term results of laparoscopically assisted
uterovestibular anastomosis in patients with cervical atresia and complete absence
of the vagina
Study Design
Sixteen consecutive patients with cervical atresia and complete absence of the vagina
were conservatively treated with laparoscopically assisted uterovestibular anastomosis
in 2 tertiary care referral centers. The follow-up assessments included clinical examination,
determination of the presence and quality of sexual intercourse, and vaginoscopy.
Results
All patients underwent laparoscopically assisted uterovestibular anastomosis. No perioperative
complications occurred. The mean follow-up period was 8 ± 3.2 years. In all patients,
the length of the neovagina was greater than 4 cm at 1 year after the surgery and
approximately 6 cm after 2 years. After the start of sexual intercourse, the neovagina
exceeded 7 cm in length in 2 of the 11 sexually active patients. At 12 months after
the surgery, iodine-positive epithelium was present in all patients and was maintained
over time. The continuity of the neovagina, neocervix, and uterine body was maintained
without further interventions in 15 of the 16 patients. During the follow-up, 11 patients
were sexually active, 5 were married, 4 were seeking conception, and 2 had spontaneous
pregnancy.
Conclusions
Laparoscopically assisted uterovestibular anastomosis seems to be a safe and effective
treatment for patients with cervical atresia and complete absence of the vagina, at
least in terms of the recovery of menstrual function and sexual activity.
Key Words
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Article info
Publication history
Published online: April 27, 2022
Accepted:
April 20,
2022
Received in revised form:
April 14,
2022
Received:
July 14,
2021
Identification
Copyright
© 2022 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
