Uterine cervix and proximal third of vagina agenesis with functional uterus: Case report and literature review

Abstract

Objectives: We aimed to describe the case of a patient presenting cervix agenesis with presence of vagina and functioning uterus. Methods: A 19-year-old patient was referred to Human Reproduction service due to primary amenorrhea, cyclic pelvic pain, and dyspareunia. She was diagnosed with cervical and vaginal agenesis, and menstrual flow suppression was the chosen treatment. Results: Regarding treatment options, hysterectomy is the classic treatment; however, due to advances in minimally invasive surgery and reproductive medicine, procedures such as uterine-vaginal anastomosis have been proposed. Young patients with no current reproductive wish, may opt for hormonal suppression of the menstrual flow to minimize cyclical discomfort and prevent or treat possible foci of endometriosis. However, for those seeking pregnancy, techniques of assisted reproduction can be considered. The approach should always be individualized, considering the anatomical details, clinical aspects, and patient’s opinion. Conclusions: Management of cervical agenesis is a challenge due to the complexity of the malformation and the difficulty in restoring and preserving fertility. Lastly, report such rare conditions and its treatment options, seems to be beneficial to help other patients with similar conditions.