Case Report|Articles in Press

Dienogest Use for Recurrent Pyosalpinx as a Long-Term Complication of Cloacal Exstrophy: A Case Report

Published:February 12, 2023DOI:



      Cloacal exstrophy (CE) is a rare congenital disease that requires multiple surgeries for complex gastrointestinal and genitourinary anomalies. Long-term complications are not uncommon; however, they are poorly reported. Pyosalpinx is sometimes encountered during CE management in adolescents and young adults.


      A 28-year-old woman with a history of CE presented with fever, lower abdominal pain, and vomiting and was diagnosed with left pyosalpinx. Computed tomography-guided drainage and intravenous antibiotic administration were successful; however, she had 2 readmissions for recurrent pyosalpinx 1 week after discharge and again 4 months later. She was administered Dienogest, a synthetic progestin, to prevent recurrent pyosalpinx and had no recurrence for 8 months.

      Summary and Conclusion

      Dienogest is a conservative treatment choice for preventing the recurrence of pyosalpinx for patients with CE.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Pediatric and Adolescent Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Phillips TM
        Spectrum of Cloacal Exstrophy.
        in: Seminars in Pediatric Surgery. 20. 2011: 113-118
        • Musleh L
        • Privitera L
        • Paraboschi I
        • et al.
        Long-term active problems in patients with cloacal exstrophy: a systematic review.
        J Pediatr Surg. 2022; 57: 339-347
        • Breech L
        Gynecologic concerns in patients with cloacal anomaly.
        Semin Pediatr Surg. 2016; 25: 90-95
        • Brunham RC
        • Gottlieb SL
        • Paavonen J
        Pelvic inflammatory disease.
        N Engl J Med. 2015; 372: 2039-2048
        • Naiditch JA
        • Radhakrishnan J
        • Chin AC
        • et al.
        Fate of the uterus in 46XX cloacal exstrophy patients.
        J Pediatr Surg. 2013; 48: 2043-2046
        • Fumino S
        • Iwai N
        • Tokiwa K
        • et al.
        Tubo-ovarian abscess after colonic vaginoplasty for high cloacal anomaly in a 13-year-old girl.
        Eur J Pediatr Surg. 2002; 12: 345-347
        • Uludag SZ
        • Demirtas E
        • Sahin Y
        • Aygen EM
        Dienogest reduces endometrioma volume and endometriosis-related pain symptoms.
        J Obstet Gynaecol. 2021; 41: 1246-1251
        • Vannuccini S
        • Clemenza S
        • Rossi M
        • Petraglia F
        Hormonal treatments for endometriosis: the endocrine background.
        Rev Endocr Metab Disord. 2022; 23: 333-355