Complex genital malformation: ectopic ureter ending in a supposed mesonephric duct in a woman with renal agenesis and ipsilateral blind hemivagina.
ABSTRACT We present a clinical case of a patient with left renal agenesis and ipsilateral blind hemivagina who also had one or more atretic ectopic ureters opening into supposed mesonephric duct, which in turn opened into, or joined onto, the ipsilateral hemicervix, continuing with the blind hemivagina. The diagram of this complex genitourinary malformation would strongly support our hypothesis of the embryology of the human vagina as deriving from the Wolffian ducts and the Mullerian tubercle.
- [Show abstract] [Hide abstract]
ABSTRACT: To retrospectively review cases of unilateral vaginal or cervical atresia with ipsilateral renal agenesis at our institution and to analyze the clinical presentation, diagnostic pitfalls, management, and embryological implications for the vaginal origin that arise from this syndrome. A retrospective observational study that included 52 patients diagnosed with this syndrome between 1998 and 2008 at Peking Union Medical College Hospital. The median age at diagnosis was 21.5 years, and the median time between the first onset of symptoms and diagnosis was 12 months. The most common presenting complaints were dysmenorrhea, purulent discharge and irregular spotting, despite the wide spectrum of symptoms at referral. Patients with and without a communication between the two hemivaginas or hemiuteri had different clinical characteristics. Of the patients, 59.6% had an obstruction on the right side. Of patients who had received a check-up prior to referral, 92.9% (n=28) had been misdiagnosed, and 53.9% had received inappropriate surgery as therapy. The pathology of the resected septum showed squamous epithelium in 13 samples, while 5 samples had epithelium with paramesonephric characteristics. Knowledge of the origins and clinical presentation of this syndrome is the foundation for correct and timely diagnosis and treatment. Moreover, this unique anomaly may offer essential clues for determining the embryological origins of the vagina and cervix.European journal of obstetrics, gynecology, and reproductive biology 08/2013; · 1.97 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: Objective To assess the role of different imaging modalities including ultrasonography, hysterosalpingogram, and magnetic resonance imaging in detection of variable Müllerian anomalies. Preoperative proper diagnosis data about Müllerian anomalies necessary for clear indications of how and when to operate.Patients and methodsA retrospective MRI study of 34 patients was done in the period from February 2008 to February 2010, their age ranging from 3 months to 38 years (mean 24 years), with uterovaginal anomalies. Ultrasonography was performed for all cases; HSG was performed in 16 cases before MRI imaging.ResultsMRI is the most reliable method for evaluating uterovaginal anomalies, particularly in pediatrics and virgins. MRI is an accurate examination for identification and categorization of MDAs and should be carried out prior to any surgery, in this study MRI allowed correct diagnosis of 34 uterine anomalies (accuracy 100%) whereas US was correct in 30 out of 34 cases (accuracy 88%). HSG had a limited role as cannot be preformed for virgins, and cannot identify non-communicating horns in unicornuate cases.ConclusionMRI is the examination of choice in uterovaginal anomalies. Endovaginal ultrasound cannot be preformed for children or females who have never had sexual intercourse. TAUS have not proved completely reliable in Müllerian duct anomalies.The Egyptian Journal of Radiology and Nuclear Medicine. 12/2010; 41(4):517–523.