title: Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner's syndrome.
abstract: 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.
authors.affiliation: Department of Gynaecology, Obstetrics and Pathophysiology of Human Reproduction, University of Naples Federico II, Naples, Italy. cdispie@tin.it <cdispie@tin.it>
authors.forename: Attilio
authors.initials: A
authors.lastname: Di Spiezio Sardo
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.forename: Maria Carolina
authors.initials: MC
authors.lastname: Salerno
authors.forename: Stefania
authors.initials: S
authors.lastname: Sparice
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bifulco
authors.forename: Maurizio
authors.initials: M
authors.lastname: Guida
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
mesh_terms: 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*