Endoscopically monitored canalization for treatment of congenital cervical atresia: the least invasive approach.
OBJECTIVE
To study feasibility, safety, and anatomic and functional outcomes of endoscopically monitored canalization for treatment of congenital cervical atresia.


METHODS
Case series with description of the technique.


METHODS
Assiut University Women's Health Center.


METHODS
Five with congenital cervical atresia, two of them with associated vaginal aplasia.


METHODS
The three cases with isolated cervical atresia underwent laparoscopic canalization under vaginoscopic monitoring (LC-VM). The two cases with associated vaginal aplasia underwent laparoscopic canalization under tactile monitoring (LC-TM). Cystoscopy was done for all cases to ensure bladder and urethral integrity.


METHODS
Operative time, complication rate, menstrual pattern, and reintervention rate.


RESULTS
The LC-VM procedure was performed successfully in three cases within 20-25 minutes. The two cases with associated vaginal aplasia underwent LC-TM; one them was successful and the other was complicated with bladder puncture. Follow-up ranged from 3 to 36 months, and all had regular menstruation.


CONCLUSIONS
Laparoscopic canalization under vaginoscopic monitoring is a simple, effective, and minimally invasive way of management of isolated cervical atresia. However it seems not to be the ideal technique and needs further refinements for treatment of cervical atresia associated with vaginal aplasia.
El Saman
Ali M
AM
Department of Obstetrics and Gynecology, Faculty of Medicine, Women's Health University Center, Assiut University, Assiut, Egypt. ali_elsaman@yahoo.com
D000293:Adolescent; D002404:Catheterization / Q000379:methods; D002584:Cervix Uteri / Q000002:abnormalities* / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods*; D016896:Treatment Outcome