Partial Cervico-Vaginal Aplasia with Functional Endometrium: A Case Report On a Simple Recanalization Technique for Outflow Reconstruction in Low-Resource Settings
DOI:
https://doi.org/10.37762/jgmds.12-4.750Keywords:
Pelvic Pain, Cervicovaginal Hypoplasia, Müllerian DuctsAbstract
A 13- year- old girl presented with cyclical pelvic pain and primary amenorrhea, revealing a rare complex cervicovaginal hypoplasia with hematometra. Diagnosis was confirmed through clinical examination, ultrasound, and MRI, emphasizing the importance of rectal examination when vaginal inspection was inconclusive. Surgical management involved a novel, cost-effective Foley catheter technique that combined an abdomino-vaginal pull-through with two-phase stenting (using a gauze mold and a balloon catheter) to establish neocervicovaginal patency. Initial drainage of 500 mL hematometra was achieved, but adhesions required reintervention with balloon stenting and psychiatric support for compliance. This case highlights three key innovations:1 a modified approach for low-resource settings, a structured adhesion prevention protocol, and integrated psychosocial care-addressing gaps in adolescent gynecological management.2,3 The technique has a minimally invasive nature, and dynamic stenting outperformed traditional methods (e.g., McIndoe vaginoplasty), aligning with ACOG’s multidisciplinary care guidelines. Challenges included the risk of restenosis, requiring vigilant follow-up. This case and approach offer a practical, holistic solution for complex Müllerian anomalies, emphasizing diagnostic precision, surgical adaptability, and psychosocial support in pubertal patients. Written informed consent was obtained from the patient for publication of this case report and accompanying images.
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Copyright (c) 2025 Naheed Parveen, Sadia Shoukat, Erum Samreen Siddiqui, Sakeena Ahmed4, Nadia Shoukat
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