Ultrasound-assisted repair of a unique case of distal vaginal agenesis.
OBJECTIVE
To describe a unique vaginal outlet obstruction and its ultrasound-assisted surgical correction.


METHODS
Case report.


METHODS
An academic medical center.


METHODS
A 12-year-old girl was seen with cyclic abdominal pain, nausea, and an abdominal mass. External genital examination revealed no vaginal opening or dimple. Transabdominal ultrasound revealed a large hematometrocolpos 5 cm proximal to the perineum, with an otherwise normal-appearing uterus and ovaries.


METHODS
Surgical treatment included perineal incision, creation of a 5-cm passage through connective tissue, drainage of the hematometrocolpos, and mobilization of the proximal vagina, allowing for pull-through vaginoplasty. Ultrasound guidance was used throughout the surgery and allowed for a safe transperineal approach. A vaginal form was placed in the neovagina.


METHODS
Follow-up clinical evaluation and pelvic ultrasonography.


RESULTS
A well-healed perineum and patent 5-cm-long vagina were observed at 4-month follow-up. The patient reported three regular menses. Postoperative pelvic ultrasound scan was normal.


CONCLUSIONS
We describe a unique case of isolated distal vaginal agenesis of significant length that was successfully treated via a perineal approach with the intra-operative assistance of ultrasound guidance.
Kresowik
Jessica
J
The University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA.
Ryan
Ginny L
GL
Austin
J Christopher
JC
Van Voorhis
Bradley J
BJ
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D014463:Ultrasonography; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery