Background: The Vagina is a composite structure formed partly from the mullerian duct and partly from urogential sinus. Most of the patients with mullerian agenesis have small rudimentary uterus without any endometria...Background: The Vagina is a composite structure formed partly from the mullerian duct and partly from urogential sinus. Most of the patients with mullerian agenesis have small rudimentary uterus without any endometrial cavity, 7% - 8% may have functioning uterus. Case: A 15 years old girl admitted with primary amenorrhea, cyclical abdominal pain, hematometra and complete vaginal agenesis. Surgical correction is the mainstay of treatment in patients with functioning uterus and absent vagina. Vaginoplasty was done to reconstruct a neovagina using amnion graft and establish uterovaginal continuity. In this case we have used only perineal approach to dissect the neovagina and identify the cervix with formation of a patent drainage tract and adequate vaginal length of 9 cm. Conclusion: In rare cases of obstructed functioning uterus by complete vaginal agenesis, vaginoplasty effectively restores anatomy and function by an overall minimal operative morbidity. Human amnion provides excellent results in neovaginal reconstruction.展开更多
The disorder of sex development is a rare disorder that usually occurs in early childhood.As adults,those with disorder of sexual development present with gynecomastia,primary amenorrhea,and primary infertility,which ...The disorder of sex development is a rare disorder that usually occurs in early childhood.As adults,those with disorder of sexual development present with gynecomastia,primary amenorrhea,and primary infertility,which often causes great psychological impact.We report a unique case of a male adult hermaphrodite presenting with hematometra and hematosalpinx.Early management including psychiatry counseling,gender reassignment,and surgery is essential.Our patient underwent müllerian tissue removal with phallus reconstruction.展开更多
文摘Background: The Vagina is a composite structure formed partly from the mullerian duct and partly from urogential sinus. Most of the patients with mullerian agenesis have small rudimentary uterus without any endometrial cavity, 7% - 8% may have functioning uterus. Case: A 15 years old girl admitted with primary amenorrhea, cyclical abdominal pain, hematometra and complete vaginal agenesis. Surgical correction is the mainstay of treatment in patients with functioning uterus and absent vagina. Vaginoplasty was done to reconstruct a neovagina using amnion graft and establish uterovaginal continuity. In this case we have used only perineal approach to dissect the neovagina and identify the cervix with formation of a patent drainage tract and adequate vaginal length of 9 cm. Conclusion: In rare cases of obstructed functioning uterus by complete vaginal agenesis, vaginoplasty effectively restores anatomy and function by an overall minimal operative morbidity. Human amnion provides excellent results in neovaginal reconstruction.
文摘The disorder of sex development is a rare disorder that usually occurs in early childhood.As adults,those with disorder of sexual development present with gynecomastia,primary amenorrhea,and primary infertility,which often causes great psychological impact.We report a unique case of a male adult hermaphrodite presenting with hematometra and hematosalpinx.Early management including psychiatry counseling,gender reassignment,and surgery is essential.Our patient underwent müllerian tissue removal with phallus reconstruction.
