RESUMO
Congenital urethrovaginal fistula is an extremely rare genitourinary anomaly. Literature search identified only five reported cases, all of which were associated with urogenital abnormalities. Transverse vaginal septum is another rare condition, resulting from abnormalities in the vertical fusion between the vaginal components of the Mullerian ducts and the urogenital sinus; and associated fistulous connection of the vagina with the urethra is even rarer. Herein we describe the case of a 35-year-old woman who presented with dyspareunia, and a 1-year history of infertility, who was found to have a urethrovaginal fistula with low transverse vaginal septum. The patient was successfully treated with excision of the septum and closure of the urethrovaginal fistula.
Assuntos
Anormalidades Urogenitais/diagnóstico , Anormalidades Urogenitais/cirurgia , Vagina/anormalidades , Fístula Vaginal/diagnóstico , Fístula Vaginal/cirurgia , Adulto , Dispareunia/complicações , Feminino , Humanos , Infertilidade Feminina/complicações , Resultado do Tratamento , Anormalidades Urogenitais/complicações , Vagina/cirurgia , Fístula Vaginal/complicações , Fístula Vaginal/congênitoRESUMO
OBJECTIVE: To evaluate the changes in subendometrial blood flow and endometrial volume after hysteroscopic lysis of severe intrauterine adhesions (IUAs). DESIGN: A pilot observational study. Forty infertile women with severe IUAs served as their own controls and were included in this study only once, to avoid selection bias. INTERVENTION: Three-dimensional power Doppler ultrasound was performed in all patients 1 day before hysteroscopic lysis of severe IUA, and repeated 1 month later, to assess subendometrial blood flow [as measured by vascularization index (VI), flow index (FI), and vascularization flow index (VFI)] and endometrial volume. Main outcome measures were subendometrial blood flow (VI, FI, VFI) and endometrial volume. RESULTS: There were statistically significant postoperative increases in endometrial volume, VI, FI, and VFI. Subendometrial blood flow improved in 14 women (35%), and menstrual improvement occurred in 15 women (37.5%). CONCLUSION: Hysteroscopic lysis of severe IUAs improves subendometrial blood flow, with subsequent increases in endometrial volume.