Feasibility of laparoscopic effusion drainage for hydrometrocolpos in neonates and younger infants

Abstract

Objective To explore the feasibility of laparoscopic effusion drainage for hydrometrocolpos in neonates and younger infants. Methods Retrospective analyses were conducted for the clinical data and follow-up information of 4 children of hydrometrocolpos undergoing laparoscope between January 2011 and December 2013. Their average age was 38 days (range, 2 days to 4 months). And the concurrent conditions included urogenital sinus malformation (n=2), cloacal malformation (n=1), Muckusick-Kaufman syndrome (n=1), congenital double uterine (n=1) and vaginal inclined diaphragin and effusion, simple hymen atresia (n=1), unilateral hydronephrosis (n=2), bilateral renal seeper & pouch colon (n=1). All received abdominal & pelvic ultrasonography, abdominal computed tomography and genital tract imaging (n=5), cystoscopy (n=3) and laparoscopic exploration (n=4). Uterine-vaginal fluid drainage was performed. And an incision of longitudinal vaginal septum was performed with fluid drainage. Among 4 cases undergoing laparoscopic fluid drainage, one underwent colostomy. Results Postoperatively the symptoms of dysuria, difficult defecation, abdominal distension, abdominal mass and vaginal mouth cyst disappeared. There was no recurrence during a follow-up period of 6 months to 3 years. Conclusions Uterus vaginal fluid is a manifestation of cloacal or urogenital sinus malformation. Female genitourinary diseases in children may present multiple malformations at the same time so that clinical diagnosis and treatment should be balanced. Laparoscopic effusion drainage is feasible for hydrometrocolpos in neonates and younger infants. Thorough physical and ultrasonic examinations, imaging studies and intraoperative endoscopy may aid the diagnosis. Comprehensive and correct understanding of disease and individualized treatment are of important significance for disease prognosis. Key words: Hydrometrocolpos; Laparoscope; Newborn and younger infant; Diagnosis and treatment