Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner's syndrome.
OBJECTIVE
To describe the successful management of a hematometra using a 5-mm continuous flow operative office hysteroscope.


METHODS
Case report.


METHODS
University of Naples "Federico II."


METHODS
A 13-year-old virgin patient affected by mosaic Turner's syndrome (45 X; 46 XX) was referred to the emergency room of the Department of Obstetrics and Gynecology after an episode of severe pelvic pain with metrorrhagia. A large hematometra was detected by transabdominal ultrasound scanning.


METHODS
Vaginoscopic hysteroscopy performed in outpatient setting.


METHODS
Complete resolution of the hematometra and related clinical symptoms.


RESULTS
Vaginoscopic approach avoided general anesthesia and preserved the integrity of her hymen. A chocolate-like fluid started to spill out from the uterine cavity as soon as the tip of hysteroscope passed through the internal uterine ostium. A transabdominal ultrasound performed 2 days later showed resolution of the hematometra. Success of the procedure was confirmed by the resolution of all clinical symptoms.


CONCLUSIONS
In selected cases, with intact outflow tract, outpatient vaginoscopic hysteroscopy might represent the therapeutic technique of choice in case of hematometra, even in the case of virgin patients.
Di Spiezio Sardo
Attilio
A
Department of Gynaecology, Obstetrics and Pathophysiology of Human Reproduction, University of Naples Federico II, Naples, Italy. cdispie@tin.it <cdispie@tin.it>
Di Carlo
Costantino
C
Salerno
Maria Carolina
MC
Sparice
Stefania
S
Bifulco
Giuseppe
G
Guida
Maurizio
M
Nappi
Carmine
C
D000293:Adolescent; D004322:Drainage / Q000379:methods*; D005260:Female; D006409:Hematometra / Q000601:surgery*; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D012746:Sexual Abstinence; D016896:Treatment Outcome; D014424:Turner Syndrome / Q000601:surgery*