Management of cervical atresia and vaginal aplasia leading to hematometra and endometriosis in a young patient: a case report

Gagan Lata, Akanksha Nigam, S. Mittal, Sushil Mittal
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2025 · vol. 14(11) , pp. 4029–4032 · doi:10.18203/2320-1770.ijrcog20253559 · W4415680552
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This case report describes the successful management of a 24-year-old female with cervicovaginal atresia, hematometra, and endometriosis via hysterectomy.

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This case report describes the management of a 24-year-old female presenting with cervicovaginal atresia, a rare congenital anomaly characterized by the complete absence or severe underdevelopment of the cervix and vagina. The patient suffered from hematometra due to obstructed menstrual flow, which subsequently led to the development of endometriosis and pelvic masses. The clinical team performed a hysterectomy to relieve the obstruction and address the resulting pathology, noting that surgical intervention should be expedited when hematometra is present. This paper is centrally about endometriosis — specifically as a secondary complication arising from obstructive reproductive tract anomalies like cervical atresia.

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Abstract

Cervicovaginal atresia is a rare congenital anomaly of the female reproductive system where there is a complete absence or severe underdevelopment of the cervix and /or vagina usually presenting in adolescence with severe abdominal pain and primary amenorrhoea which can further lead to endometriosis and pelvic mass. Hereby, we are reporting such a rare case of cervicovaginal atresia in 24 years female who was managed with hysterectomy. Surgery is not strictly required during menstruation, but if there is hematometra, the surgery should be performed as soon as possible to relieve the obstruction. This case reporting aims to offer insights and recommendations for future research on cervicovaginal atresia, ultimately striving to enhance the quality of life for affected individuals.
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Management of cervical atresia and vaginal aplasia leading to hematometra and endometriosis in a young patient: a case report DOI: https://doi.org/10.18203/2320-1770.ijrcog20253559Keywords: Cervical atresia, Hematometra, Endometriosis, HysterectomyAbstract Cervicovaginal atresia is a rare congenital anomaly of the female reproductive system where there is a complete absence or severe underdevelopment of the cervix and /or vagina usually presenting in adolescence with severe abdominal pain and primary amenorrhoea which can further lead to endometriosis and pelvic mass. Hereby, we are reporting such a rare case of cervicovaginal atresia in 24 years female who was managed with hysterectomy. Surgery is not strictly required during menstruation, but if there is hematometra, the surgery should be performed as soon as possible to relieve the obstruction. This case reporting aims to offer insights and recommendations for future research on cervicovaginal atresia, ultimately striving to enhance the quality of life for affected individuals. Metrics References Dietrich JE, Millar DM. Obstructive reproductive tract anomalies. J Pediatr Adolesc Gynecol. 2014;27(6):396-402. DOI: https://doi.org/10.1016/j.jpag.2014.09.001 Aci´en P, Aci MI. The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod. 2011;17(5):693-705. DOI: https://doi.org/10.1093/humupd/dmr021 Mei L, Zhang H, Chen Y, Niu X. Clinical features of congenital complete vaginal atresia combined with cervical aplasia: a retrospective study of 19 patients and literature review. Congenit Anom. 2021;61(4):127-32. DOI: https://doi.org/10.1111/cga.12417 Zayed M, Fouad R, Elsetohy KA, Hashem AT, AbdAllah AA, Fathi AI. Uterovaginal anastomosis for cases of Cryptomenorrhea due to cervical atresia with vaginal aplasia: benefits and risk. J Pediatr Adolesc Gynecol. 2017;30,(6):641-5. DOI: https://doi.org/10.1016/j.jpag.2017.06.001 Xie Z, Xiaoping Z, Jiandong L, Ningzhi Z, Hong X, Yongying L, et al. Clinical characteristics of congenital cervical atresia based on anatomy and ultrasound: a retrospective study of 32 cases. Eur J Med Res. 2014;19(1):10. DOI: https://doi.org/10.1186/2047-783X-19-10 Wilson D, Bordoni B. Embryology, Mullerian Ducts (Paramesonephric Ducts), in StatPearls, Treasure Island (FL): StatPearls Publishing, 2024. Gala FB, Gala KB, Gala BM. Magnetic resonance imaging of uterine cervix: a pictorial essay. Indian J. Radiol. Imaging. 2021;31(2):454-67. DOI: https://doi.org/10.1055/s-0041-1734377 Abramowicz S, Oden S, Joutel N, Roman H, Gromez A. Laparoscopic creation of a neovagina by Vecchietti's technique: anatomic and functional results. Gynecol Obst Fertil. 2013;41(1):4-9. DOI: https://doi.org/10.1016/j.gyobfe.2012.11.002

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