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Differential diagnosis of aplasia of the uterus and vagina


Differential diagnosis of aplasia of the uterus and vagina

Differential diagnosis of aplasia of the uterus and vagina

Symptoms and course of the disease

The main complaint with which 15-16-year-old girls go to the doctor is the absence of menstruation. At an older age, patients complain of the impossibility of sexual activity.

Treatment of the disease

The only way to treat the Rokitansky-Kustner syndrome is the plastic formation of the neovagina - colpopoiesis from the pelvic peritoneum or sigmoid colon. Bougienage and dilatation of the rudimentary vagina (colpoelongation) is possible only if it is of sufficient length - 2-4 cm. The purpose of the intervention is to remove the obstacle to a normal sexual life.

Diagnosis of the disease

The standard examination includes:
- collection of anamnesis;
- examination of the genital external organs;
- assessment of physical and sexual development;
- laboratory and general clinical studies;
- bacterioscopic and bacteriological examination of secretions from the genital tract;
- vaginal probing;
- rectal abdominal examination;
- Ultrasound examination of the urinary and reproductive systems.

These studies are enough to accurately determine the variant of the defect and the choice of the method of surgical treatment.

The physique of the patient is usually correct, sexual and physical development is correlated with the age norm. Sexual secondary characteristics are quite well formed. When conducting a gynecological examination, it is recorded that the external genital organs develop correctly. When probing the vagina, the specialist finds behind the hymen a small depression about a centimeter or a half long. When conducting a rectal abdominal examination in a typical place, the uterus cannot be determined, a cord is palpated there. Attachments cannot be identified either.

During the ultrasound examination, the ovaries and the absolute absence of the uterus are detected. In some cases, patients can detect in parallel all kinds of malformations of the urinary system:
kidney aplasia;
lumbar or pelvic dystopia of the kidney;
the phenomenon of doubling the pelvicalyceal system.

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