Laparoscopic colo-vaginoplasty for cervicovaginal atresia in an adolescent girl

Abstract

Cervico-vaginal atresia is a rare anomaly. To accomplish bowel vaginoplasty entirely by laparoscopy is technically quite challenging. Our patient is a 14-year-old girl who presented with complaints of amenorrhea and a lump in the abdomen due to Cervico-vaginal atresia. An unsuccessful intervention to dilate the vagina was attempted in another hospital. An MRI scan showed hematometra & hydrosalpinx, Cervico-vaginal atresia, and a 2cm long distal vagina. After eight months, we performed total laparoscopic sigmoid colo-vaginoplasty, with colo-vaginal, utero-colic and colo-colic anastomoses. The patient was discharged after 5 days. Ten days later she presented with adhesive small bowel obstruction, which was managed laparoscopically. Follow-up endoscopy after one month revealed patent anastomoses. She has been asymptomatic for 8 months, with regular menstruation. Vaginal reconstruction using sigmoid colon is an effective option providing excellent anatomical and functional result. To accomplish the entire procedure laparoscopically is technically challenging but a feasible option one.

Keywords

• Cervicovaginal atresia
• Vaginal reconstruction
• Laparoscopy