CASE REPORT   

Minerva Obstetrics and Gynecology 2023 Feb 16

DOI: 10.23736/S2724-606X.23.05224-7

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Menopause: a trigger for simultaneous development of ulcerative colitis in sigmoid neovagina and residual colorectum?

Massimo CANDIANI ¹, Francesco FEDELE ¹, Simona DI FATTA ¹, Gianluca TACCAGNI ², Carolina DOLCI ¹, Alessandro F. RUFFOLO ¹ ✉

¹ Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy; ² Unit of Pathology, IRCCS San Raffaele Hospital, Milan, Italy

Vaginoplasty using sigmoid colon is a common technique used for the creation of a neovagina. However, the risk of adverse neovaginal bowel events is a common mentioned disadvantage. We report the case of a woman submitted to intestinal vaginoplasty for Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome at the age of 24 years who, with the onset of menopause, developed blood-stained vaginal discharge. Almost simultaneously, the patients complained chronic abdominal pain in lower left quadrant and prolonged diarrhea. General exams, Pap smear test, microbiological tests and viral test for HPV were negative. Neovaginal biopsies were suggestive for inflammatory bowel disease (IBD) of moderate activity and colonic biopsies were suggestive for ulcerative colitis (UC). The development of UC in the sigmoid neovagina and, almost simultaneously, in the remaining colon with onset of menopause raises important questions about etiology and pathogenesis of these diseases. Our case suggests that menopause may consider a trigger for the development of UC, due to the changes in the colon surface permeability related to menopause.

KEY WORDS: Inflammatory bowel diseases; Colitis, ulcerative; Menopause