Reconstructive Surgical Management of Cryptomenorrhoea

Abstract

The vagina is a composite structure made up of the mullerian duct and the urogential sinus. The majority of patients with mullerian agenesis have a small rudimentary uterus with no endometrial cavity; however, 7% to 8% may have a functioning uterus. A 15-year-old girl with primary amenorrhea, cyclical abdominal pain, hematometra, and complete vaginal agenesis was admitted. In patients with a functioning uterus but no vagina, surgical correction is the mainstay of treatment. Vaginoplasty was performed to repair a neovagina with an amnion graft and restore uterovaginal continuity. In this case, we only employed the perineal method to dissect the neovagina and recognize the cervix, resulting in the formation of a patent drainage tract and a 9-cm vaginal length. Vaginal plasty efficiently recovers anatomy and function in rare cases of obstructed functioning uterus caused by complete vaginal agenesis with minimum overall operational morbidity. Excellent outcomes are obtained when using human aminion for neovaginal reconstruction.