Re: agenesis of vagina
From: James S Smeltzer MD (gaperina@mindspring.com)
Wed May 5 19:52:19 1999
Valerie,
As you are aware from reading their description they are aware of the
treatments of MAIER-Rokitanski-Kuster-Hauser and their problems. The
question your colleague raised is a cogent and difficult one, as patency
maintenance rates are not very good in women who are not sexually active.
If you have information that can help them to answer their question
regarding maintenance of patency please give it for ALL our benefit. Else,
please reload your dump truck and find another place to leave it.
Jim S
At 09:31 PM 4/29/1999 -0500, you wrote:
>Wkere are these people from? Vaginal agenesis is a well known disease
entity. It can be managed surgically or with dilators. The formal name is
Rokantinsky -Kuster-Hauser syndrome.
>VMR
>
>>>> "rbiernat" <rbiernat@polbox.com> 4/20/99 7:44:31 AM >>>
>14 years old girl, was admitted to our hospital due to severe abdominal
>pain. Her condition was stable, there no signs of peritonismus. Per
>rectum examination shown enlarged, painful uterus and tumour behind the
>uterus. There were no vagina. Sonography performed with transrectal
>probe shown: Dilated uterus and cervix filled with hypoechogenic mass
>(fluid). ovaries and salpinx looked like normal.
>Under general anaesthesia canal between rectum and bladder was performed
>between two layers of soft tissue but we could not reach the lower part
>of uterus, so we decided to make laparotomy - after opening peritoneum
>enlarged, soft uterus and dilated cervix filled with blood and normal
>ovaries and salpinx were visualised. Through small incision in the lower
>part of uterus about 300 ml of haemolised blood was aspirated and then
>using Cheatle's forceps an external ostium of cervix was found and
>connected with the canal performed before ("artificial vagina"). Foley's
>catheter was inserted to the uterus through the big, stiff catheter
>placed in the "vagina". We closed abdomen typically.
>If anyone have any experience how to preserved the patency of the canal.
>We will be very grateful for any suggestion advises and references.
>
>Your sincerely
>>>Magdalena Biernat MD
>
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