A novel approach to cervical reconstruction using vaginal mucosa-lined polytetrafluoroethylene graft in congenital agenesis of the cervix

Fertil Steril. 2011 Jun;95(7):2433.e5-8. doi: 10.1016/j.fertnstert.2011.02.007. Epub 2011 Mar 5.

Abstract

Objective: To report a novel technique for cervical reconstruction in a patient with congenital agenesis of the cervix.

Design: Case report.

Setting: University-based tertiary care hospital.

Patient(s): A woman with congenital absence of the cervix, functional vagina, and adenomyosis uteri.

Intervention(s): Laparoscopic-assisted creation of an uterovaginal fistula followed by placement of a polytetrafluoroethylene graft lined with vaginal mucosa graft to create the neocervix.

Main outcome measure(s): Follow-up examinations with the hysteroscope confirmed unobstructed menstrual outflow through the patent neocervix.

Result(s): The neocervix was completely mucosalized on the inner surface by 12 days postoperatively. The patient had return of menstrual bleeding at 4 weeks postoperatively. She has resumed normal sexual activities and had maintained regular menstrual cycles at the 6-month clinical follow-up. There were no complications related to the graft.

Conclusion(s): Prosthetic reconstruction of the cervix using vaginal mucosa-lined polytetrafluoroethylene is easy to perform and effective. It offers an alternative treatment option for patients with cervical agenesis to preserve their reproductive potential.

Publication types

  • Case Reports

MeSH terms

  • Blood Vessel Prosthesis*
  • Cervix Uteri / abnormalities
  • Cervix Uteri / physiopathology
  • Cervix Uteri / surgery*
  • Endometriosis / complications
  • Endometriosis / surgery
  • Female
  • Genital Diseases, Female / congenital
  • Genital Diseases, Female / physiopathology
  • Genital Diseases, Female / surgery*
  • Gynecologic Surgical Procedures / instrumentation*
  • Humans
  • Hysteroscopy
  • Laparoscopy
  • Menstrual Cycle
  • Mucous Membrane / transplantation
  • Polytetrafluoroethylene*
  • Prosthesis Design
  • Prosthesis Implantation / instrumentation*
  • Sexual Behavior
  • Surgically-Created Structures*
  • Treatment Outcome
  • Uterine Diseases / complications
  • Uterine Diseases / surgery
  • Vagina / surgery*
  • Young Adult

Substances

  • Polytetrafluoroethylene