Paul Krishna Gopal, Kosuri Kalyan Chakravarthi, Bayad Hasam
Department of Obstetrics and Gynaecology, Varun Arjun Medical College and Rohilkhand Hospital, Banthara, India.
Department of Anatomy, Varun Arjun Medical College and Rohilkhand Hospital, Banthara, India.
Obstet Gynecol Sci. 2020 Sep;63(5):655-659. doi: 10.5468/ogs.20046. Epub 2020 Jul 30.
Congenital Mullerian duct malformations are a challenging group of conditions for surgeons and need surgical experience and skill. Accordingly, the aim of this study is to present the diagnosis, surgical management, and clinical implications of congenital uterovaginal abnormalities.
Between 1980 and 2015, 8 patients with congenital uterovaginal abnormalities were diagnosed. In one patient a unique case of an unusual horseshoe shaped double uterus communicating via a transverse canal along with agenesis of the cervix and vagina was noted, and utero-vaginal agenesis was diagnosed in 6 patients. Complete androgen insensitivity syndrome with its female phenotype associated with bilateral testicular tissue in the inguinal canal with an accompanying absence of the ovaries, uterus, uterine tubes, vagina, and an imperforate hymen, was diagnosed in one patient. Clinical examination of all the patients revealed well-developed secondary sexual characteristics. A modified McIndoe vaginoplasty procedure was the surgical treatment common to all patients to treat vaginal agenesis. The surgery was performed by a consultant (Dr. K.G. Paul) using the standardized surgical technique.
An unusual Mullerian duct anomaly, uterus bicornisacollis, was successfully corrected by uteroplasty and a new cervix was constructed. Complete vaginal agenesis was corrected by a modified McIndoe vaginoplasty technique. None of the patients had any significant post-operative complications.
Knowledge of congenital uterovaginal abnormalities diagnosed in this study is essential for surgeons, clinical anatomists, radiologists, and morphologists who may increase the success of their diagnostic evaluations and surgical approaches to the region.
先天性苗勒管畸形对外科医生来说是一组具有挑战性的病症，需要手术经验和技巧。因此，本研究的目的是介绍先天性子宫阴道异常的诊断、手术管理及临床意义。
1980年至2015年间，诊断出8例先天性子宫阴道异常患者。其中1例患者呈现独特病例，为罕见的马蹄形双子宫，通过横向管道连通，同时伴有宫颈和阴道发育不全；6例患者被诊断为子宫阴道发育不全。1例患者被诊断为完全雄激素不敏感综合征，其女性表型与腹股沟管内双侧睾丸组织相关，同时伴有卵巢、子宫、输卵管、阴道缺失及处女膜闭锁。所有患者的临床检查均显示第二性征发育良好。改良的麦金杜阴道成形术是所有患者治疗阴道发育不全的共同手术治疗方法。手术由一位顾问医生（K.G.保罗医生）采用标准化手术技术进行。
一种罕见的苗勒管异常，双角子宫颈子宫，通过子宫成形术成功矫正，并构建了新的宫颈。完全阴道发育不全通过改良的麦金杜阴道成形术得到矫正。所有患者均未出现任何严重的术后并发症。
本研究中诊断出的先天性子宫阴道异常的相关知识，对于外科医生、临床解剖学家、放射科医生和形态学家来说至关重要，这可能会提高他们对该区域诊断评估和手术方法的成功率。
