A Postconization Hematometra Revealed a Rare Case of Endocervical Bone Metaplasia

Luca Giannella, Maria Carolina Gelli, Kabala Mfuta, Sonia Prandi
In: Journal of Lower Genital Tract Disease · 2013 · vol. 18(1) , pp. E19–E22 · doi:10.1097/lgt.0b013e3182914eef · PMID:23959299 · W2008742245
article OA: closed CC0 ⤵ 2 in-corpus citations
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This case report describes a young woman who developed postconization hematometra due to endocervical bone metaplasia, successfully treated with hysteroscopy.

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Abstract

BACKGROUND: Hematometra is an unusual occurrence in young women undergoing conization; moreover, osseous metaplasia of the uterine cervix is a very rare event, with 7 cases in the literature. A postconization hematometra due to endocervical ossification is a unique occurrence. The authors report such an event. CASE: A young woman undergoing conization developed progressive hypoamenorrhea with pelvic pain. Pregnancy test was negative and a transvaginal ultrasound showed an image of suspected hematometra. Diagnostic hysteroscopy showed an endocervical obstruction due to a bone formation of the uterine cervix, which was removed with an office operative hysteroscopy. After surgery, the patient restored normal menstrual cycle. Histological examination revealed a cervical bone metaplasia. CONCLUSIONS: In premenopausal women undergoing conization, the appearance of a progressive hypoamenorrhea with pelvic pain could suggest a cervical mechanical obstruction that could be an uncommon stenosis. Despite this case represents a very rare event, a postconization hematometra due to an endocervical ossification can be managed with an office operative hysteroscopy.

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