title: Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty.
abstract: BACKGROUND
  Cervicovaginal atresia is a rare Mullerian anomaly. The management of cervicovaginal atresia has evolved from historical recommendations of hysterectomy to various reconstructive procedures more recently. The latter carries a risk of significant morbidity and unknown fertility. We present our experience in the management of this complex anomaly.
  
  
  METHODS
  Twenty patients with cervicovaginal atresia were operated in our hospital from January 2004 through December 2013. The details of their anatomical variations and functional outcomes were analyzed.
  
  
  RESULTS
  Eighteen out of twenty patients had cervical agenesis. Two patients had cervical hypoplasia. All patients underwent utero-coloneovaginoplasty. Post operatively, all patients have regular menstrual cycles. One patient is married, sexually active and has satisfactory coital function. One patient had a bowel anastomotic leak that required a diversion ileostomy. Two patients developed mild stenosis. One patient has mild neovaginal mucosal prolapse. No patient has developed pyometra.
  
  
  CONCLUSIONS
  Patients with cervicovaginal atresia need to be counselled about the various reconstructive options available and the potential risks. Social and economic factor play a significant role in determining the plan of management. For patients from conservative societies, utero-coloneovaginoplasty provides a safe conduit for the passage of menstrual flow and coitus, at the cost of permanent infertility.
authors.affiliation: Department of Paediatric Surgery, Christian Medical College, Vellore, 632004, India, skisku@yahoo.com.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Kisku
authors.forename: Lilly
authors.initials: L
authors.lastname: Varghese
authors.forename: Aruna
authors.initials: A
authors.lastname: Kekre
authors.forename: Sudipta
authors.initials: S
authors.lastname: Sen
authors.forename: Sampath
authors.initials: S
authors.lastname: Karl
authors.forename: John
authors.initials: J
authors.lastname: Mathai
authors.forename: Reju Joseph
authors.initials: RJ
authors.lastname: Thomas
authors.forename: Ravi Kishore
authors.initials: RK
authors.lastname: Barla
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D002584:Cervix Uteri / Q000002:abnormalities* / Q000601:surgery; D002648:Child; D003106:Colon / Q000601:surgery; D005260:Female; D006409:Hematometra / Q000150:complications* / Q000601:surgery; D006801:Humans; D008598:Menstruation; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012725:Sexual Behavior; D016896:Treatment Outcome; D014599:Uterus / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery; D055815:Young Adult