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完全纵隔子宫、双宫颈、阴道闭锁和同侧肾缺如患者的临床特征和处理。

Clinical characteristics and management of patients with complete septate uterus, double cervix, obstructed hemivagina, and ipsilateral renal agenesis.

机构信息

Department of Obstetrics and Gynecology, The Third Xiangya Hospital of Central South University, Changsha, China.

出版信息

J Obstet Gynaecol Res. 2021 Apr;47(4):1497-1501. doi: 10.1111/jog.14662. Epub 2021 Jan 6.

Abstract

AIM

To analyze the clinical characteristics and management of patients with complete septate uterus, double cervix, obstructed hemivagina, and ipsilateral renal agenesis.

METHODS

This retrospective study reviewed the medical records of 17 patients with complete septate uterus, double cervix, obstructed hemivagina, and ipsilateral renal agenesis admitted to the Third Xiangya Hospital of Central South University between June 2007 and December 2019.

RESULTS

The median age at surgery was 23 years. The most common presenting complaint was infertility. Seven (41.2%) patients were misdiagnosed previously. The obstruction was complete in five patients. All 17 patients underwent vaginoplasty, in which seven adolescent girls underwent vaginoscopic vaginal septum resections. Eight patients underwent hysteroscopic resections of the uterine septum for infertility or spontaneous miscarriage. Laparoscopy was performed in seven patients for specific indications, and only one patient was found to have pelvic endometriosis during the laparoscopy. During the follow-up, seven patients wished to conceive, and there were five living infants (four cesarean deliveries at term and one preterm vaginal delivery).

CONCLUSION

Complete septate uterus with double cervix, obstructed hemivagina, and ipsilateral renal agenesis is an variant of obstructed hemivagina and ipsilateral renal agenesis syndrome. Consequently, healthcare providers should be aware of this potential variant.

摘要

目的

分析完全纵隔子宫、双宫颈、单侧阴道闭锁伴同侧肾发育不全患者的临床特征和处理方法。

方法

本回顾性研究纳入了 2007 年 6 月至 2019 年 12 月期间在中南大学湘雅三医院就诊的 17 例完全纵隔子宫、双宫颈、单侧阴道闭锁伴同侧肾发育不全患者的病历资料。

结果

手术时的中位年龄为 23 岁。最常见的主诉为不孕。7 例(41.2%)患者此前曾被误诊。5 例患者存在完全性闭锁。17 例患者均接受了阴道成形术,其中 7 例青春期少女接受了阴道镜下阴道纵隔切除术。8 例因不孕或自然流产行宫腔镜下子宫纵隔切除术。7 例患者因特殊指征行腹腔镜检查,仅 1 例患者在腹腔镜检查中发现盆腔子宫内膜异位症。随访期间,7 例患者希望妊娠,其中 5 例活产(4 例足月剖宫产,1 例早产阴道分娩)。

结论

完全纵隔子宫、双宫颈、单侧阴道闭锁伴同侧肾发育不全是单侧阴道闭锁伴同侧肾发育不全综合征的一种变异型。因此,医疗保健提供者应对此潜在变异型保持警惕。

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