Utero-Vaginal Reanastomosis for Cervical Agenesis

Abstract

Video Objective The objective of this video is to review the types of cervical agenesis and dysgenesis, methods of diagnosis, and the surgical technique used to correct this type of mullerian anomaly. Setting A young adult with history of primary amenorrhea, pelvic pain found to have endometriosis and cervical agenesis presents for surgical correction of her cervical agenesis at a large academic center with a robust minimally invasive gynecologic surgical group. Interventions The patient with cervical agenesis underwent a laparoscopic utero-vaginal reanastomosis. A stent was left in situ for maturation of the new cervical fistulous tract between the uterus and the vagina. Conclusion Patients with cervical malformations, such as cervical agenesis or dysgenesis, that want to establish and maintain cyclical menses and/or to preserve fertility can be offered an utero-vaginal reanastomosis. This surgery can be safely and efficaciously performed with laparoscopy. Though the first reanastomosis procedures performed resulted in high morbidity and mortality, recent surgical outcomes have been more promising with subsequent successful pregnancies and continued patency of the created outflow tract.