Service of Obstetrics and Gynecology, University General Hospital of Alicante, Spain.
Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):472-5. doi: 10.1016/j.ejogrb.2011.09.008. Epub 2011 Oct 4.
To describe the diagnostic and therapeutic process for a congenital exceptional anomaly. To analyze the pathogenesis of the embryologic anomalies associated with menouria and congenital vesicovaginal fistula (VVF).
The case of a 28-year-old female with menouria and impossibility of consummating coitus is described. The diagnostic method is analyzed. The type of treatment is described and finally we conclude with a hypothesis about embryology of congenital anomalies with VVF and menouria.
For management of anomalies as congenital VVF, imaging tests including cystography and urography could not correctly visualize the fistulous tract. It was identified by cystoscopy, performed during the time of menouria. Surgical treatment consisted in repairing the VVF and vaginoplasty according to the McIndoe technique.
All women with menouria need complete investigation with exhaustive exploration, analytic evaluation, ultrasound, imaging tests (principally magnetic resonance) and, very importantly, cystoscopy on the days of menouria. Surgical treatment must be careful and individualized. This case allows us to hypothesise that the blind vagina encountered reflects an anomaly of correct urogenital sinus development.
描述一种先天性异常的诊断和治疗过程。分析与月经过多和先天性膀胱阴道瘘（VVF）相关的胚胎发育异常的发病机制。
描述一名 28 岁女性月经过多且无法完成性交的病例。分析诊断方法。描述治疗类型，最后对伴有 VVF 和月经过多的先天性异常的胚胎学提出假设。
对于先天性 VVF 等异常的处理，包括膀胱造影和尿路造影在内的影像学检查无法正确显示瘘管。在月经过多时进行的膀胱镜检查中发现了瘘管。手术治疗包括修复 VVF 和根据 McIndoe 技术进行阴道成形术。
所有月经过多的女性均需要进行全面检查，包括详细探查、分析评估、超声、影像学检查（主要是磁共振），并且非常重要的是在月经过多期间进行膀胱镜检查。手术治疗必须谨慎且个体化。该病例使我们假设遇到的盲阴道反映了正确的尿生殖窦发育异常。
