Uterocervicoplasty with a bladder mucosa layer for the treatment of complete cervical agenesis.
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.
Bugmann
Philippe
P
Clinique et Policlinique de Chirurgie Pédiatrique, Hôpital des Enfants, Geneva, Switzerland. bugmann@hcuge.ch
Amaudruz
Monique
M
Hanquinet
Sylviane
S
La Scala
Giorgio
G
Birraux
Jacques
J
Le Coultre
Claude
C
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