Endoscopically monitored canalization for treatment of congenital cervical atresia: the least invasive approach.

OBJECTIVE

To study feasibility, safety, and anatomic and functional outcomes of endoscopically monitored canalization for treatment of congenital cervical atresia.

DESIGN

Case series with description of the technique.

SETTING

Assiut University Women's Health Center.

PATIENT(S): Five with congenital cervical atresia, two of them with associated vaginal aplasia.

INTERVENTION(S): The three cases with isolated cervical atresia underwent laparoscopic canalization under vaginoscopic monitoring (LC-VM). The two cases with associated vaginal aplasia underwent laparoscopic canalization under tactile monitoring (LC-TM). Cystoscopy was done for all cases to ensure bladder and urethral integrity.

MAIN OUTCOME MEASURE(S): Operative time, complication rate, menstrual pattern, and reintervention rate.

RESULT(S): The LC-VM procedure was performed successfully in three cases within 20-25 minutes. The two cases with associated vaginal aplasia underwent LC-TM; one them was successful and the other was complicated with bladder puncture. Follow-up ranged from 3 to 36 months, and all had regular menstruation.

CONCLUSION(S): Laparoscopic canalization under vaginoscopic monitoring is a simple, effective, and minimally invasive way of management of isolated cervical atresia. However it seems not to be the ideal technique and needs further refinements for treatment of cervical atresia associated with vaginal aplasia.