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Cervicovaginal anastomosis by Gore-Tex in Mullerian agenesis

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Abstract

Objective

To determine usage of polytetrafluoroethylene, Gore-Tex, as a stent in patients with congenital cervicovaginal agenesis.

Design

Follow-up study.

Setting

Tertiary center referral hospital.

Patients

Eight patients with Mullerian agenesis who had congenital cervical agenesis, associated with partial or complete vaginal aplasia.

Interventions

Laparoscopic uterovaginal anastomosis with placement of a polytetrafluoroethylene stent for reconstruction of cervical agenesis. In cases associated with vaginal agenesis, modified McIndoe vaginoplasty was done concomitantly.

Measurements and main results

Eight patients with cervical agenesis who had partial and complete vaginal aplasia underwent vaginoplasty. Mean (SD) follow-up after surgery (3 years old). All patients except three of them, (62.5 %) experienced relief of abdominal pain and regular menstruation. Due to ascending infection three of them (37.5 %) needed reoperation. So, they underwent laparotomy. Two of these three patients had total abdominal hysterectomy and one case tolerated resection of right obstructed side of didelphys uterus, then she became pregnant spontaneously. Four out of these eight cases were married and the others were single. One out of our married patients conceived three times. Her first pregnancy was aborted. She delivered two alive babies after inserting transabdominal Shirodkar suture in her other pregnancies.

Conclusion

Uterovaginal anastomosis assisted laparoscopy with polytetrafluoroethylene (Gore-Tex) is effective and hopeful to relieve patients’ symptoms, menstruation regularity, and saving fertility. If ascending infection threatening health happens, hysterectomy will be recommended.

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Acknowledgments

We thank our reviewers for their helpful comments.

Conflict of interest

No actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Tehran Medical University, Tehran, Iran

    Zahra Rezaei & Shirin Niroumanesh

  2. Shahid Beheshti Medical University, Tehran, Iran

    Azizeh Omidvar

  3. Iran University of Science and Technology, Tehran, Iran

    Azadeh Omidvar

Authors
  1. Zahra Rezaei
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  2. Azizeh Omidvar
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  3. Shirin Niroumanesh
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  4. Azadeh Omidvar
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Correspondence to Azizeh Omidvar.

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Rezaei, Z., Omidvar, A., Niroumanesh, S. et al. Cervicovaginal anastomosis by Gore-Tex in Mullerian agenesis. Arch Gynecol Obstet 291, 467–472 (2015). https://doi.org/10.1007/s00404-014-3442-y

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  • DOI: https://doi.org/10.1007/s00404-014-3442-y

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