Health Problems Related to Female Genital Malformations: Obstructive and Complex Anomalies

The main objective was to evaluate health problems like cyclic pelvic pain, hematocavity and hematometra, as well as potentially dangerous complications like “ectopic” horn pregnancies in obstructive and complex female genital tract malformations. Primary amenorrhea and cyclic pelvic pain are the main presenting symptoms when these patients reach puberty. Teenage girls, who have any obstruction to menstrual flow, may present hematocolpos or hematometra and are at increased risk for endometriosis. Class U4a hemi-uterus is susceptible to gynecologic and obstetric complications, while the incidence of ectopic pregnancy is as high as 22 % and therefore laparoscopic removal of the rudimentary horn and its tube is indicated when this uterine anomaly is diagnosed. The incidence of renal abnormalities in patients presenting with Mullerian anomalies is approximately 30 % and this has certainly clinical implications not only concerning symptomatology, but also for scheduling complex multidisciplinary surgical interventions. These individuals present quite frequently emotional trauma, anxiety and even depression and psychologic support and counseling is therefore recommended. Restoration management of the non-communicating horn should be an open issue for further research. The involvement of a multi-disciplinary team for the pre-operative management, surgical approach and follow-up is of utmost importance for the lege artis approach of these patients and centralization of cervices will ensure these individuals receive holistic and high quality medical care. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

Grimbizis G, Gordts S, Sardo A, Brucker S, De Angelis C, Gergolet M, Li T, Tanos V, Brölman H, Gianaroli L, Campo R. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Gynecol Surg. 2013;10:199–212. Grimbizis G, Gordts S, Sardo A, Brucker S, De Angelis C, Gergolet M, Li T, Tanos V, Brölman H, Gianaroli L, Campo R. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032–44. Heinonen P. Unicornuate uterus and rudimentary horn. Fertil Steril. 1997;68:224–30. Joki-Erkkila M, Heinonen P. Presenting and long-term clinical implications and fecundity in females with obstructing vaginal malformations. J Pediatr Adolesc Gynecol. 2003;16:307–12. Sanfilippo J, Watkins N, Schikler K. Endometriosis in association with uterine abnormalities. Am J Obstet Gynecol. 1986;154:39–43. Taylor E, McComb P. Removal of a non-communicating horn may not affect persistence or recurrence of endometriosis: a case report. J Obstet Gynaecol Can. 2007;29:247–9. Pados G. Laparoscopic hemi-hysterectomy in treatment of unicornuate uterus with rudimentary horn. In: Dequesne J, Pados G, Paschopoulos M, de Wilde R, editors. Advanced minimal invasive surgery: in the theatre and in the office. Bologna: Medimond Publishing, Italy; 2005. p. 99–102. Romano S, Bustan M, Ben-Shlomo I, Shalev E. A novel surgical approach to obstructed hemiuterus: sonographically guided hysteroscopic correction. Hum Reprod. 2000;15(7):1578–9. Fedele L, Bianchi S, Tozzi L, Marchini M, Busacca M. Fertility in women with unicornuate uterus. Br J Obstet Gynaecol. 1995;102:1007–9. Tonguç A, Ergün B, Baki Ş, Neşe Y. Rudimentary uterine horn pregnancy: a mystery diagnosis. Fertil Steril. 2009;92:2037.e1–3. Scholtz M. A full-time pregnancy in a rudimentary horn of the uterus. Br J Obstet Gynaecol. 1951;58:293–6. Oppelt P, von Have M, Paulsen M, Strissel P, Strick R, Brucker S, Wallwiener D, Beckmann M. Female genital malformations and their associated abnormalities. Fertil Steril. 2007;87:335–42. Sheih C, Liu M, Hung C, Yang K, Chen W, Lin C. Renal abnormalities in schoolchildren. Pediatrics. 1989;84:1086–90. Hall-Craggs M, Kirkham A, Creighton S. Renal and urological abnormalities occurring with Mullerian anomalies. J Pediatr Urol. 2013;9:27–32. Edmonds K. Congenital malformations of the genital tract and their management. Best Pract Res Clinic Obstet Gynaecol. 2003;17(1):19–40. Poland M, Evans T. Psychologic aspects of vaginal agenesis. J Reprod Med. 1985;30:340–4. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2015 Springer-Verlag London About this chapter Cite this chapter Pados, G. (2015). Health Problems Related to Female Genital Malformations: Obstructive and Complex Anomalies. In: Grimbizis, G., Campo, R., Tarlatzis, B., Gordts, S. (eds) Female Genital Tract Congenital Malformations. Springer, London. https://doi.org/10.1007/978-1-4471-5146-3_12 Download citation DOI: https://doi.org/10.1007/978-1-4471-5146-3_12 Published: Publisher Name: Springer, London Print ISBN: 978-1-4471-5145-6 Online ISBN: 978-1-4471-5146-3 eBook Packages: MedicineMedicine (R0)