Asunto(s)
Cuello del Útero/diagnóstico por imagen , Quistes/diagnóstico por imagen , Enfermedades del Cuello del Útero/diagnóstico por imagen , Dolor Abdominal/etiología , Dolor Abdominal/prevención & control , Adulto , Amenorrea/etiología , Amenorrea/prevención & control , Cuello del Útero/cirugía , Quistes/metabolismo , Quistes/fisiopatología , Quistes/cirugía , Diagnóstico Diferencial , Drenaje , Femenino , Hematómetra/etiología , Hematómetra/prevención & control , Hematómetra/terapia , Humanos , Imagen por Resonancia Magnética , Moco/diagnóstico por imagen , Moco/metabolismo , Resultado del Tratamiento , Enfermedades del Cuello del Útero/fisiopatología , Enfermedades del Cuello del Útero/cirugía , Neoplasias del Cuello Uterino/diagnósticoRESUMEN
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.
Asunto(s)
Anomalías Múltiples/cirugía , Himen/anomalías , Trastornos de la Menstruación/cirugía , Conductos Paramesonéfricos/cirugía , Complicaciones Posoperatorias/etiología , Punciones/efectos adversos , Adherencias Tisulares/etiología , Vagina/cirugía , Dolor Abdominal/etiología , Dolor Abdominal/prevención & control , Anomalías Múltiples/fisiopatología , Adolescente , Amenorrea/etiología , Amenorrea/prevención & control , Anomalías Congénitas , Dilatación , Femenino , Hematocolpos/etiología , Hematocolpos/prevención & control , Hematómetra/etiología , Hematómetra/prevención & control , Humanos , Himen/fisiopatología , Himen/cirugía , Japón , Productos para la Higiene Menstrual , Trastornos de la Menstruación/fisiopatología , Conductos Paramesonéfricos/anomalías , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/cirugía , Recurrencia , Reoperación/efectos adversos , Adherencias Tisulares/prevención & control , Adherencias Tisulares/cirugía , Resultado del Tratamiento , Vagina/anomalíasRESUMEN
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.
