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Re: Vaginal Stricture after hyserectomy From: Anatoli I. Garkusha (midilover@yahoo.com) Fri Sep 15 08:50:58 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: james connerth: "- Letter" Previous message: james connerth: "Re: The death of Cytotec/misoprostol as we know it" Maybe in reply to: Michael Beason,MD: "Vaginal Stricture after hyserectomy" Thanx for your interestiong letter, dear colleague. A Real quiz. The stricture has a close relation to the operation, to my mind. Also: "and ultrasound reveals a normal vaginal vault proximal to this >stricture". Is there a way to have a look at the sonographic data, could images be sent ? Regards, Anatoli Garkusha, MD, sonologist. Kiev, Ukraine. --τΕΝΑ: Vaginal Stricture after hyserectomy >I have been consulted on a very unusual case. A 42 yr old nulliparous >female underwent a TVH,BSO for fibroids and bleeding at a teaching >hospital. According to the op. report (that was dictated 3 months >after the procedure) there were no complications. The op. note read >like the textbook description from Telinde's Gyn. The resident claims >not to have performed any type of vaginoplasty, A&P repair or >perineoplasty. He denies any type of complications. However, 3 months >post-op, this patient has severe stenosis of the distal vagina. It >involves 360 degrees of the vaginal orifice and the scar tissue is very >dense and almost avascular. The stricture extends 3 cm into the vagina >and ultrasound reveals a normal vaginal vault proximal to this >stricture. >The resident denies any complications during this procedure. However, >this stenosis is such that a pencil cannot be inserted into the vagina >without difficulty. >She has no history of previous abnormal scar formation or healing >difficulties. She previously underwent a breast lesion excision without >scar formation. >I can only speculate that some type of extreme trauma occured during the >procedure. Possibly excessive retraction with resultant trauma, perhaps >an inadvertant cautery burn (not likely since 360 degree involvement of >vaginal opening) . >I have conducted an extensive literature search and have not uncovered a >single article describing such a complication. >Does anyone have any thoughts about this strange case and does anyone >know of any reference or literature articles that I could be referred >to? > Thank you very much. Michael Beason,MD Next message: james connerth: "- Letter" Previous message: james connerth: "Re: The death of Cytotec/misoprostol as we know it" Maybe in reply to: Michael Beason,MD: "Vaginal Stricture after hyserectomy"

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