A combined surgical and radiologic technique for creating a functional neo-endocervical canal in a case of partial congenital cervical atresia.

OBJECTIVE

To recanalize the endocervical canal in a patient with partial congenital cervical atresia.

DESIGN

Case report.

SETTING

University hospital.

PATIENT: A 16-year-old girl referred with a history of primary amenorrhea, polycystic ovaries, and intermittent abdominal pain. Physical examination revealed a normal vagina and external cervical os, but magnetic resonance imaging revealed a solid endocervical tract.

INTERVENTION(S): At laparotomy the endometrial cavity was accessed transfundally and outlined by injection of water-soluble contrast. A trocar needle was guided transvaginally into the uterus, the tract was dilated, and a 12F stent was placed. Oral contraceptives (OCs) and antibiotics were continued postoperatively.

MAIN OUTCOME MEASURE(S): Hysterosalpingography and clinical follow-up.

RESULT(S): The operation and postoperative course were uneventful. Withdrawal bleeding occurred at 8 weeks, after discontinuation of the OCs, at which time the stent was expelled. Later follow-up revealed recurrent narrowing, and the stent was replaced for 14 more weeks. After stent removal, regular menses continued (7 months to date).

CONCLUSION

In select cases of congenital cervical atresia, recanalization may be safely performed with the use of the combined surgical-radiologic technique described, with good short-term outcome.