Dienogest Use for Recurrent Pyosalpinx as a Long-Term Complication of Cloacal Exstrophy: A Case Report

J Pediatr Adolesc Gynecol. 2023 Jun;36(3):328-330. doi: 10.1016/j.jpag.2023.02.002. Epub 2023 Feb 12.

Abstract

Background: Cloacal exstrophy (CE) is a rare congenital disease that requires multiple surgeries for complex gastrointestinal and genitourinary anomalies. Long-term complications are not uncommon; however, they are poorly reported. Pyosalpinx is sometimes encountered during CE management in adolescents and young adults.

Case: A 28-year-old woman with a history of CE presented with fever, lower abdominal pain, and vomiting and was diagnosed with left pyosalpinx. Computed tomography-guided drainage and intravenous antibiotic administration were successful; however, she had 2 readmissions for recurrent pyosalpinx 1 week after discharge and again 4 months later. She was administered Dienogest, a synthetic progestin, to prevent recurrent pyosalpinx and had no recurrence for 8 months.

Summary and conclusion: Dienogest is a conservative treatment choice for preventing the recurrence of pyosalpinx for patients with CE.

Keywords: Cloacal exstrophy; Dienogest; Long-term complication; Pelvic inflammatory disease; Pyosalpinx.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain
  • Adolescent
  • Adult
  • Bladder Exstrophy* / complications
  • Female
  • Humans
  • Nandrolone*
  • Salpingitis* / etiology
  • Urogenital Abnormalities* / complications
  • Young Adult

Substances

  • dienogest
  • Nandrolone