Uterine Isthmus Atresia Conservatively Treated by Laparoscopy and Transvaginal Utero-Cervical Anastomosis

Candiani M, Fedele F, Dolci C, Grecchi G, Petrone M and Ruffolo AF

Department of Obstetrics and Gynecology, IRCCS San Raffaele Scientific Institute, University Vita and Salute, Milan, Italy

^*Correspondance to: Alessandro Ferdinando Ruffolo 

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Abstract:

Uterine Isthmus Atresia (UIA) is an unusual complete separation of uterine body from cervix, often excessively treated (hysterectomy). This report aims to describe a uterine-sparing technique for UIA treatment. This is the case of a 14-year-old girl referred for primary amenorrhea and cyclic pelvic pain. Imaging study was suggestive for UIA, hematometra and bilateral hematosalpinx. The patient was submitted to a combined laparoscopic-transvaginal end-to-end utero-cervical anastomosis. A stable anastomosis was obtained. At 3-month follow up the patient referred regular painless menses. Ultrasound identified the new connection between the cervix and the uterine body. Hysteroscopy revealed a short but regular cervical canal, widely permeable and regularly connected with the uterine cavity. For UIA treatment, when the cervical segment is intact, an end-to-end utero-cervical anastomosis is feasible and effective.

Keywords:

Uterine isthmus atresia; Mullerian anomalies; genital anomalies; utero-cervical anastomosis; Laparoscopy

Cite the Article:

Candiani M, Fedele F, Dolci C, Grecchi G, Petrone M, Ruffolo AF. Uterine Isthmus Atresia Conservatively Treated by Laparoscopy and Transvaginal Utero-Cervical Anastomosis. World J Surg Surgical Res. 2022; 5: 1422..