Modern methods of surgical treatment of obstructive genital malformations in girls

Abstract

Congenital anomalies of female genital tract in children and adolescents are more commonly detected at the age of menarche with several symptoms caused by obstruction. These diseases are rare, but without timely diagnostics and management they can cause a number of serious complications. This article is aimed to review modern approaches to diagnostics and management of this pathology and to highlight some aspects that require further research. A literature search was conducted using the following databases: MEDLINE, Google Scholar, eLIBRARY, international guidelines and clinical recommendations. Key words that were used for search were: «congenital malformations», «distal vaginal atresia», «imperforated hymen», «OHVIRA», «transverse vaginal septum», «hematocolpos», «obstructive uterovaginal anomalies», «surgical treatment in pediatrics». International clinical trials which had been analysed by the authors were included in the review. They have explored the current literature related to the following obstructive malformations: distal vaginal atresia, transverse vaginal septum, imperforated hymen and Herlin–Werner–Wunderlich syndrome. Main conclusions are: further studies with a larger sample of patients, longer follow-up, long-term outcomes and effective preventive measures against complications. Another unresolved question is the age which can be recommended for surgical treatment of obstructive malformations. Potentials for developing new algorithms of earlier diagnostics are also among research priorities.