Passovoy defect: A cause of severe operative hemorrhage in obstetrics and gynecology

Abstract

inal or rectovaginal examination on a hypoestrogenic patient. However, continuity between the uterus and the vagina must be documented in these patients prior to hormonal replacement therapy. Otherwise, an unexpected association with vaginal agenesis may result in hematometra or retrograde menstruation once cycles are established. This concern over estrogen replacement has heretofore been more theoretical than actual because there have been no previous case reports of miillerian agenesis coexisting with hypogonadotropic hypogonadism. In this case, a nonfunctional uterine remnant was found and estrogen therapy was given with only vaginal dilatation. However, congenital absence of the vagina may exist with a functional uterus, and, if this association is found, surgical intervention would be necessary.