Fujimoto V Y, Miller J H, Klein N A, Soules M R
Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, USA.
Am J Obstet Gynecol. 1997 Dec;177(6):1419-25. doi: 10.1016/s0002-9378(97)70085-1.
Our aim was to evaluate the clinical course and management of congenital cervical atresia.
This retrospective analysis included 7 patients referred to our clinic and a review of the medical literature.
Including this case series, 58 cases of congenital cervical atresia have been reported in the literature. Forty-eight percent of patients had isolated congenital cervical atresia with a normal vagina whereas the remainder had either complete or partial vaginal atresia ("shortened blind vaginal pouches"). Surgical management has included abdominal hysterectomy or uterovaginal cannulation with or without vaginoplasty. In 59% of patients who underwent uterovaginal canalization procedures (23/39), normal menstrual bleeding was achieved. Four of these patients subsequently became pregnant and were delivered at term.
Surgical canalization in selected patients with congenital cervical atresia can be successfully performed to provide patients an opportunity for conservative management, resulting in normal menstrual bleeding, resolution of cyclic pelvic pain, and some potential (albeit limited) for fertility.
我们的目的是评估先天性宫颈闭锁的临床病程及治疗方法。
这项回顾性分析纳入了转诊至我们诊所的7例患者，并对医学文献进行了综述。
包括本病例系列在内，文献中已报道58例先天性宫颈闭锁病例。48%的患者为单纯性先天性宫颈闭锁且阴道正常，其余患者则合并完全性或部分性阴道闭锁（“缩短的盲端阴道袋”）。手术治疗方法包括经腹子宫切除术或子宫阴道插管术，可联合或不联合阴道成形术。在接受子宫阴道插管术的患者中，59%（23/39）实现了正常月经出血。其中4例患者随后怀孕并足月分娩。
对选定的先天性宫颈闭锁患者成功实施手术插管，可为患者提供保守治疗的机会，从而实现正常月经出血、缓解周期性盆腔疼痛，并具有一定的生育潜力（尽管有限）。
