title: Uterocervicoplasty with a bladder mucosa layer for the treatment of complete cervical agenesis.
abstract: OBJECTIVE
  To create an endocervical canal in a patient with a complete cervical agenesis.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A 12-year-old girl presented with lower abdominal pain. On examination, complete vaginal agenesis was noted, with a 2-cm vaginal dimple. A pelvic magnetic resonance imaging scan disclosed an hematometra and absence of the cervix and vagina.
  
  
  METHODS
  Initial surgical therapy consisted of a vaginoplasty with a sigmoid bowel segment and opening of the uterus by puncture and stenting. The cervical permeation failed, with immediate complete stenosis. A new attempt was made through a low sagittal hysterotomy by removing a central muscular cylinder and lining the channel with a free tubularized bladder mucosa graft. A stent was left in place.
  
  
  METHODS
  Hysteroscopy, hysterography, and clinical follow-up evaluation.
  
  
  RESULTS
  The cervical stent was removed after 5 months. A hysterography and hysteroscopy confirmed the permeability of the cervix, which was lined by a well-vascularized longitudinally folded mucosa. Regular menses had been noted for more than 3 years as of this report.
  
  
  CONCLUSIONS
  Cervicoplasty with mucosal lining permits the creation of a patent cervical canal, even in the reputedly unfavorable forms of congenital cervical agenesis.
authors.affiliation: Clinique et Policlinique de Chirurgie Pédiatrique, Hôpital des Enfants, Geneva, Switzerland. bugmann@hcuge.ch
authors.forename: Philippe
authors.initials: P
authors.lastname: Bugmann
authors.forename: Monique
authors.initials: M
authors.lastname: Amaudruz
authors.forename: Sylviane
authors.initials: S
authors.lastname: Hanquinet
authors.forename: Giorgio
authors.initials: G
authors.lastname: La Scala
authors.forename: Jacques
authors.initials: J
authors.lastname: Birraux
authors.forename: Claude
authors.initials: C
authors.lastname: Le Coultre
mesh_terms: D002584:Cervix Uteri / Q000002:abnormalities* / Q000601:surgery*; D002648:Child; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008279:Magnetic Resonance Imaging; D009092:Mucous Membrane; D015607:Stents; D019738:Surgically-Created Structures; D001743:Urinary Bladder; D014599:Uterus / Q000601:surgery*; D014621:Vagina / Q000002:abnormalities / Q000601:surgery