- 産婦人科の進歩 (ISSN:03708446)
- vol.42, no.4, pp.493-498, 1990 (Released:2011-07-05)
Congenital defect of the vagina is estimated to occur once in every 4, 000-5, 000 female births, and about 5% of those women have a funcitioning uterus. We present a case of congenital defect of the vagina with functioning uterus. The patient was a 15-year-old girl, who had had cyclic lower abdominal cramping since 12 years of age. Her height was 155 cm and her weight 55 Kg. Her vital sings were normal, and her secondary sexual characteristics were adequate. The basal body temperature was biphasic. On pelvic examination, the external genitalia were normal. The vagina terminated blindly 1 cm inside the introitus. Rectal examination revealed that the uterus was normal in size and shape. Chromosome study showed a 46XX karyotype. Intravenous pyelography revealed no urinary tract anomalies. We selected simple surgical reconstruction of the vagina with uterine conservation. The uterine body was incised vertically to reveal a bicornate uterine cavity which ended blindly above the hypoplastic and non-canalized cervix. The blind termination of the vagina was incised and elongated, and.the potential vaginal cavity was canalized and dilated. Stenosis of the neovagina was prevented by the insertion of a Hegar's cervical dilator (no. 18) for ten minutes every night and sanitary tampons during the daytime. Cyclic and painless menstruations now occur without any stenosis or consequent infection.Other reports of congenital defect of the vagina with functioning uterus are summarized and discussed.