Use of office hysteroscopy to empty a very large hematometra in a young virgin patient with mosaic Turner's syndrome.

OBJECTIVE

To describe the successful management of a hematometra using a 5-mm continuous flow operative office hysteroscope.

DESIGN

Case report.

SETTING

University of Naples "Federico II."

PATIENT(S): A 13-year-old virgin patient affected by mosaic Turner's syndrome (45 X; 46 XX) was referred to the emergency room of the Department of Obstetrics and Gynecology after an episode of severe pelvic pain with metrorrhagia. A large hematometra was detected by transabdominal ultrasound scanning.

INTERVENTION(S): Vaginoscopic hysteroscopy performed in outpatient setting.

MAIN OUTCOME MEASURE(S): Complete resolution of the hematometra and related clinical symptoms.

RESULT(S): Vaginoscopic approach avoided general anesthesia and preserved the integrity of her hymen. A chocolate-like fluid started to spill out from the uterine cavity as soon as the tip of hysteroscope passed through the internal uterine ostium. A transabdominal ultrasound performed 2 days later showed resolution of the hematometra. Success of the procedure was confirmed by the resolution of all clinical symptoms.

CONCLUSION(S): In selected cases, with intact outflow tract, outpatient vaginoscopic hysteroscopy might represent the therapeutic technique of choice in case of hematometra, even in the case of virgin patients.