Primary Amenorrhea - A One Year Review

Abstract

Objective:Primary amenorrhea occurs in about 0.1-2% of reproductive age group women. The aim of this study was to evaluate the etiology and management of patients with primary amenorrhea in a tertiary referral centre. Material and Methods:The study was performed using 13 complete medical records of women with primary amenorrhea who attended the Department of Obstetrics and Gynecology, Maxcure Suyosha Hospital, Hyderabad, India between May 2015 and May 2016. Out of the 13 cases, 8 had 46XX Mullerian agenesis (MRKH syndrome), 4 had 46XY Androgen Insensitivity Syndrome (AIS) and 1 had 45XO/46XY Turner mosaic syndrome. Neovagina formation was done in 8 cases, bilateral gonadectomy was done in 5 cases and bilateral salpingectomy in 3 cases by laparoscopic methods. Results:Minimally invasive removal of gonads was accomplished with less morbidity to patients and without any complications. Histopathology of gonads revealed a sertoli cell pattern in 3 cases and gonadoblastoma in 2 cases. Successful application of surgical technique of neovagina creation using Interceed was achieved in patients with vaginal agenesis. Conclusion:Management of primary amenorrhea is a multi–modal approach with the type of intervention based on the etiology. A thorough evaluation to identify the cause for amenorrhea and timely surgical intervention would produce a better cosmetic and functional result and address the psychosocial issues associated with this condition.