Cargando…

Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches

The objective of this case series was to describe different uterus-preserving surgical approaches and outcomes in patients with complex obstructive Müllerian duct malformation caused by cervical and/or vaginal anomalies. A retrospective analysis was performed including patients undergoing uterovagin...

Descripción completa

Detalles Bibliográficos
Autores principales: Hoeller, Alice, Steinmacher, Sahra, Schlammerl, Katharina, Hoopmann, Markus, Reisenauer, Christl, Hattermann, Valerie, Brucker, Sara Y., Rall, Katharina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457300/
https://www.ncbi.nlm.nih.gov/pubmed/36078957
http://dx.doi.org/10.3390/jcm11175026
_version_ 1784786021341200384
author Hoeller, Alice
Steinmacher, Sahra
Schlammerl, Katharina
Hoopmann, Markus
Reisenauer, Christl
Hattermann, Valerie
Brucker, Sara Y.
Rall, Katharina
author_facet Hoeller, Alice
Steinmacher, Sahra
Schlammerl, Katharina
Hoopmann, Markus
Reisenauer, Christl
Hattermann, Valerie
Brucker, Sara Y.
Rall, Katharina
author_sort Hoeller, Alice
collection PubMed
description The objective of this case series was to describe different uterus-preserving surgical approaches and outcomes in patients with complex obstructive Müllerian duct malformation caused by cervical and/or vaginal anomalies. A retrospective analysis was performed including patients undergoing uterovaginal anastomosis (n = 6) or presenting for follow-up (n = 2) at the Department for Gynecology at the University of Tuebingen between 2017 and 2022. Uterovaginal anastomosis was performed with a one-step combined vaginal and laparoscopic approach (method A), a two-step/primary open abdominal approach with primary vaginal reconstruction followed by abdominal uterovaginal anastomosis after vaginal epithelization (method B) or an attempted one-step approach followed by secondary open abdominal uterovaginal anastomosis due to reobstruction (method A/B). Patients presented at a mean age of 15 years. Two patients were treated by method A, four by method B and two by method A/B. Functional anastomosis was established in seven of eight patients, with normal vaginal length in all patients. Concerning uterovaginal anastomosis, the primary open abdominal approach with or without previous vaginal reconstruction seems to have a higher success rate with fewer procedures and should be implemented as standard surgical therapy for complex obstructive genital malformations including the cervix.
format Online
Article
Text
id pubmed-9457300
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94573002022-09-09 Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches Hoeller, Alice Steinmacher, Sahra Schlammerl, Katharina Hoopmann, Markus Reisenauer, Christl Hattermann, Valerie Brucker, Sara Y. Rall, Katharina J Clin Med Article The objective of this case series was to describe different uterus-preserving surgical approaches and outcomes in patients with complex obstructive Müllerian duct malformation caused by cervical and/or vaginal anomalies. A retrospective analysis was performed including patients undergoing uterovaginal anastomosis (n = 6) or presenting for follow-up (n = 2) at the Department for Gynecology at the University of Tuebingen between 2017 and 2022. Uterovaginal anastomosis was performed with a one-step combined vaginal and laparoscopic approach (method A), a two-step/primary open abdominal approach with primary vaginal reconstruction followed by abdominal uterovaginal anastomosis after vaginal epithelization (method B) or an attempted one-step approach followed by secondary open abdominal uterovaginal anastomosis due to reobstruction (method A/B). Patients presented at a mean age of 15 years. Two patients were treated by method A, four by method B and two by method A/B. Functional anastomosis was established in seven of eight patients, with normal vaginal length in all patients. Concerning uterovaginal anastomosis, the primary open abdominal approach with or without previous vaginal reconstruction seems to have a higher success rate with fewer procedures and should be implemented as standard surgical therapy for complex obstructive genital malformations including the cervix. MDPI 2022-08-26 /pmc/articles/PMC9457300/ /pubmed/36078957 http://dx.doi.org/10.3390/jcm11175026 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hoeller, Alice
Steinmacher, Sahra
Schlammerl, Katharina
Hoopmann, Markus
Reisenauer, Christl
Hattermann, Valerie
Brucker, Sara Y.
Rall, Katharina
Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title_full Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title_fullStr Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title_full_unstemmed Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title_short Reassessment of Surgical Procedures for Complex Obstructive Genital Malformations: A Case Series on Different Surgical Approaches
title_sort reassessment of surgical procedures for complex obstructive genital malformations: a case series on different surgical approaches
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457300/
https://www.ncbi.nlm.nih.gov/pubmed/36078957
http://dx.doi.org/10.3390/jcm11175026
work_keys_str_mv AT hoelleralice reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT steinmachersahra reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT schlammerlkatharina reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT hoopmannmarkus reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT reisenauerchristl reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT hattermannvalerie reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT bruckersaray reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches
AT rallkatharina reassessmentofsurgicalproceduresforcomplexobstructivegenitalmalformationsacaseseriesondifferentsurgicalapproaches