CONGENITAL VAGINAL ATRESIA MANAGEMENT OUTCOMES IN CHILDREN

Tai An Nguyen 1,, Thi Truc Linh Nguyen 1, Duc Duy Vu 1, Quoc Tung Pham 1, Trung Cuong Ho 2, Thi Phuong Tran1, Van Giau Le1, Nguyen Hien Nhan Pham 1, Dai Phu Tran2, Thanh Hung Le 2
1 University of Medicine and Pharmacy at Ho Chi Minh City
2 Children’s Hospital 1

Main Article Content

Abstract

Background: Vaginal atresia is a rare congenital obstruction lesions of the female genital tract. Objectives: To explore the characteristics and to investigate outcomes of vaginal atresia treament in Children’s Hospital 1. Materials and methods: Retrospective study. Description of a series of cases with 35 children who underwent surgery for vaginal atresia between January 1st, 2012 and June 1st, 2022. Results: There were thirty-five children met the sampling criteria, identified and charted. The mean age was 12.5±1.5 years. Abdominal pain was the main reason causes of admissions. Throughout examinations, it was realized that the vital symptom was no vaginal opening accounting for 94.3%, and 80% of listed children had developed secondary genitalia. All pediatric patients were evaluated physically with 2 normal ovaries by ultrasound and magnetic resonance. The average distance from the perineum to the level of the obstruction was 26.4±13.5 mm. All patients underwent pull-through vaginoplasty with similar operative techniques. The average operative time was 65 ± 31.7 minutes. After the first surgery, the symptoms were gone in 88.6% cases. Conclusion: Vaginal atresia is managed with pull-through vaginoplasty.

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References

1. Ugur M.G., Balat O., Ozturk E., Bekerecioglu M., Dikensoy E. Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre. Eur J Obstet Gynecol. 2012. 163(1), 85-90. doi:10.1016/j.ejogrb.2012.03.024.
2. Poljak D., Hoefgen H., Merritt D. Distal Vaginal Atresia. J Pediatr Adolesc Gynecol. 2020. 33, 235-236. doi:10.1016/j.jpag.2020.01.056.
3. Laufer M.R. Congenital anomalies of the hymen and vagina. UpToDate. Updated March 3, 2020. Accessed April 6, 2021, https://www.uptodate.com/contents/congenital-anomalies-ofthe-hymen-and-vagina.
4. Laufer M.R. Abnormalities of the Female Genital Tract. Pediatric Surgery (Seventh Edition). Mosby. 2012. 1591-1609.
5. Zhu L., Wong F., Lang J. Atlas of surgical correction of female genital malformation. Springer. 2015. 85-205.
6. Hillard P.J.A. Pediatric and Adolescent Gynecology Is Care for the Underserved. J Pediatr Adolesc Gynecol. 2021. 34(2),109-111. doi:https://doi.org/10.1016/j.jpag.2021.01.017.
7. Zhang M., Zhang M.X., Li G.L., Xu C.J. Congenital vaginal atresia: A report of 39 cases in a regional Obstetrics and Gynecology Hospital. J Huazhong Univ Sci Technol. 2017. 37(6), 928932. doi:10.1007/s11596-017-1829-2.
8. Dural O., Ugurlucan F.G., Yasa C., et al. A Case of Distal Vaginal Agenesis Presenting with Recurrent Urinary Tract Infection and Pyuria in a Prepubertal Girl. J Pediatr Adolesc Gynecol. 2017. 30(1), e7-e10. doi:10.1016/j.jpag.2016.08.007.
9. Zhang H., Qu H., Ning G., et al. MRI in the evaluation of obstructive reproductive tract anomalies in paediatric patients. Clinical radiology. 2017. 72(7), 612.e7-612.e15. doi:10.1016/j.crad.2017.02.002.
10. Xu S., Zhang J., Wang S., et al. MRI features and differential diagnoses of congenital vaginal atresia. Gynecol endocrinol : the official journal of the International Society of Gynecological Endocrinology. 2019. 35(9), 777-781. doi:10.1080/09513590.2019.1588875.
11. Gynecologists AcoOa. Management of acute obstructive uterovaginal anomalies. Accessed April 04, 2021. https://www.acog.org/clinical/clinical-guidance/committeeopinion/articles/2019/06/management-of-acute-obstructive-uterovaginal-anomalies.
12. Mansouri R., Dietrich J.E. Postoperative Course and Complications after Pull-through Vaginoplasty for Distal Vaginal Atresia. J Pediatr Adolesc Gynecol. 2015. 28(6), 433-6. doi:10.1016/j.jpag.2014.12.007.
13. Lê Thanh Hùng, Trần Đại Phú. Bất sản âm đạo. Phác đồ điều trị nhi khoa 2020. Bệnh viện Nhi Đồng 1. 2020. 93-94.
14. Van B.C., Willemsen W. Treatment of patients with a congenital transversal vaginal septum or a partial aplasia of the vagina. The vaginal pull-through versus the push-through technique. J Pediatr Adolesc Gynecol. 2009. 22(3), 157-61. doi:10.1016/j.jpag.2008.02.008.