Assuntos
Colo do Útero/diagnóstico por imagem , Cistos/diagnóstico por imagem , Doenças do Colo do Útero/diagnóstico por imagem , Dor Abdominal/etiologia , Dor Abdominal/prevenção & controle , Adulto , Amenorreia/etiologia , Amenorreia/prevenção & controle , Colo do Útero/cirurgia , Cistos/metabolismo , Cistos/fisiopatologia , Cistos/cirurgia , Diagnóstico Diferencial , Drenagem , Feminino , Hematometra/etiologia , Hematometra/prevenção & controle , Hematometra/terapia , Humanos , Imageamento por Ressonância Magnética , Muco/diagnóstico por imagem , Muco/metabolismo , Resultado do Tratamento , Doenças do Colo do Útero/fisiopatologia , Doenças do Colo do Útero/cirurgia , Neoplasias do Colo do Útero/diagnósticoRESUMO
Transverse vaginal septum is a residual vaginal plate composed of the Müllerian duct and urogenital sinus. Imperforate hymen results from failure of perforation of the membrane between the urogenital sinus and vaginal cavity. We report a rare case of concurrence of these two conditions. A 16-year-old girl had been treated with puncture several times for hematometra and hematocolpos from 13 years of age because of monthly occurrence of lower abdominal pain without menstrual bleeding and was referred to our hospital. Magnetic resonance imaging demonstrated hematometra, hematocolpos and expansion of the vaginal fornix. The imperforate hymen was incised and a slight adhesion at the lower vaginal cavity was detached. After that, a complete transverse vaginal septum, which was 5 mm thick, was identified. It was excised after ultrasonography-guided puncture. Although two cycles of menstrual bleeding took place, molimina recurred. Re-operation was performed 6 months after the first operation, and recurrence of adhesion in the lower vaginal cavity was identified. A silicon dilator was inserted, but she could not use it at home and instead used a tampon. Cyclic menstrual bleeding is observed 4 months after the second operation.
Assuntos
Anormalidades Múltiplas/cirurgia , Hímen/anormalidades , Distúrbios Menstruais/cirurgia , Ductos Paramesonéfricos/cirurgia , Complicações Pós-Operatórias/etiologia , Punções/efeitos adversos , Aderências Teciduais/etiologia , Vagina/cirurgia , Dor Abdominal/etiologia , Dor Abdominal/prevenção & controle , Anormalidades Múltiplas/fisiopatologia , Adolescente , Amenorreia/etiologia , Amenorreia/prevenção & controle , Anormalidades Congênitas , Dilatação , Feminino , Hematocolpia/etiologia , Hematocolpia/prevenção & controle , Hematometra/etiologia , Hematometra/prevenção & controle , Humanos , Hímen/fisiopatologia , Hímen/cirurgia , Japão , Produtos de Higiene Menstrual , Distúrbios Menstruais/fisiopatologia , Ductos Paramesonéfricos/anormalidades , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/cirurgia , Recidiva , Reoperação/efeitos adversos , Aderências Teciduais/prevenção & controle , Aderências Teciduais/cirurgia , Resultado do Tratamento , Vagina/anormalidadesRESUMO
At first, total endometrial ablation seemed extremely safe in the short term. However, as time passed, certain unique long-term complications became evident. The problem is that after this procedure, intrauterine scarring and contracture can occur. Any bleeding from persistent or regenerating endometrium behind the scar may be obstructed and cause problems such as central hematometra, cornual hematometra, postablation tubal sterilization syndrome, retrograde menstruation, and potential delay in the diagnosis of endometrial cancer. The incidence of these complications is probably understated because most radiologists and pathologists have not been educated about the findings to make the appropriate diagnosis of cornual hematometra and postablation tubal sterilization syndrome. This review will thoroughly discuss how to diagnose and treat these problems. Possible ways of preventing these long-term complications will also be discussed.