Two cases of pyometrocolpos due to distal vaginal atresia.
ABSTRACT Children with pyometrocolpos due to distal vaginal atresia may present as acutely ill, with severe obstructive uropathy and septicemia. In such patients the clinical course is markedly improved by urgent drainage of the infected cystic mass, and a temporary drainage procedure is required to allow local findings of infection to subside before definitive surgery. We present two children with pyometrocolpos with the above-mentioned clinical course, in whom percutaneous drainage with computed tomography-guided catheter placement through the lower abdominal wall was performed because of the high risks of complex drainage procedures and general anesthesia. This drainage did result in dramatically improved clinical status, and findings of local inflammation resolved within 4-6 weeks, which facilitated a later successful definitive surgical procedure.
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ABSTRACT: Developmental anomalies of the mullerian duct system represent an interesting field of disorders in obstetrics and gynecology as they can affect any of the reproductive organs from the Fallopian tubes to the hymen. The purpose of this article is to review the available treatment options for mullerian duct anomalies with special emphasis on simple and advanced surgical approaches. Surgical options are presented based on a novel treatment plan classification system adapted from the American Fertility Society classification of mullerian duct anomalies. Care was taken to include all previously termed unclassified anomalies as well as the important category of longitudinal fusion defects. Important diagnostic approaches are discussed with special emphasis on detection of associated anomalies of the urinary system and other relevant systems. Early establishment of an accurate diagnosis is important for planning management options and preventing complications in the genital organs and surrounding systems. Classifying mullerian anomalies based on the available treatment options seems logical and the inclusion of previously unclassified entities is important for a comprehensive understanding and management of this group of disorders. The surgical approach for the correction of mullerian duct anomalies is individualized to the type of malformation. The value of a given surgical procedure should be assessed on terms of its capability to improve a patient's postoperative ability to have healthy sexual relations and achieve successful reproductive outcomes.Current Women s Health Reviews 04/2010; 6(2):183-196.
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ABSTRACT: McKusick Kaufman Syndrome (MKS), a rare genetic condition, presents in the neonatal period with a classic triad of postaxial polydactyly, congenital heart disease, and hydrometrocolpos. The diagnosis is typically clinical, based on the presence of polydactyly and hydrometrocolpos. We report the case of a 13-year-old female, who was diagnosed with MKS in infancy and underwent vaginal reconstructive surgery for a urogenital sinus. She was lost to follow-up thereafter. She presented to our institution at age 13 with pyometra, pyosalpinx, and tubo-ovarian abscess due to a stenotic cervix obstructing menstrual outflow. Gynecologic follow-up is imperative in patients with history of vaginal reconstruction to monitor for hematometra from outflow obstruction to prevent life threatening secondary bacterial infections.Journal of pediatric and adolescent gynecology 03/2014; · 0.90 Impact Factor
- Edited by AShok Agarwal, 01/2010;