Successful laparoscopic sigmoid transposition for cervicovaginal agenesis in the presence of a functioning uterus: A case series

Int J Gynaecol Obstet. 2023 Jan;160(1):271-279. doi: 10.1002/ijgo.14342. Epub 2022 Jul 24.

Abstract

Objective: This study investigated the long-term outcomes of laparascopic sigmoid cervicovaginoplasty in patients with congenital cervicovaginal atresia with a functioning uterus.

Methods: In this case series study, seven patients with cervicovaginal atresia with a functioning uterus underwent laparoscopic sigmoid cervicovaginoplasty surgery between 2016 and 2020. Mean follow-up duration was 25.9 months (2-48 months). All of the patients had regular menstrual cycles. The average length of the vagina was 8.9 cm (7.6-10.5 cm). In one patient, proximal stenosis of neovagina was observed 12 months after surgery.

Results: The mean age and body mass index of the patients were 18 years (12-27 years) and 19.7 (17.6-22.4), respectively. The average time period between the initiation of disease symptoms and the operation was 52.28 months (2-156 months). There were no postoperative short-term complications. We did not perform hysterectomy in our patients. None of our patients complained of signs of low anterior resection syndrome. Two patients had sexual activities without dyspareunia, postcoital bleeding, or malodorous vaginal discharge.

Conclusion: Sigmoid cervicovaginoplasty is a safe and effective procedure with satisfactory long-term outcomes. This surgery eliminates the psychological burden of hysterectomy in these patients. Through preserving the uterus, patients may have a chance of possible future pregnancy if abdominal cerclage is performed.

Keywords: congenital cervical atresia; laparoscopic colovaginoplasty; obstructive Mullerian anomalies.

MeSH terms

  • Congenital Abnormalities* / surgery
  • Female
  • Humans
  • Laparoscopy* / methods
  • Plastic Surgery Procedures*
  • Postoperative Complications / epidemiology
  • Pregnancy
  • Rectal Neoplasms*
  • Uterus / abnormalities
  • Uterus / surgery
  • Vagina / abnormalities
  • Vagina / surgery