Double Approach Technique for Cervicovaginal Agenesis: A Case Report
DOI:
https://doi.org/10.25077/aoj.10.1.170-178.2026Keywords:
Primary amenorrhea, cervical agenesis, vaginal agenesis, mullerian anomalyAbstract
Introduction: Cervicovaginal agenesis is rare female congenital anomalies. The patients usually present with primary amenorrhoea, cyclical abdominal pain, or primary infertility. A conservative surgical approach has been proposed to alleviate obstructive symptoms, construct, and maintain the patency of the genital tract, while still preserving fertility.
Case Report: A Ms. 14 year old was referred with primary amenorrhea and cyclical abdominal pain for 5 months. Physical examination and ultrasound revealed cervical dysgenesis with proximal vaginal dygenesis. Cervical canalization using double approach (laparotomy and trasnvaginally) was done to restore the normal anatomical integrity, maintain the functional cervical canal with a theoretical advantage of protection from ascending infection, and preservation of fertility.
Discussion: Obstructed menstrual blood, causing symptoms such as primary amenorrhea, could be a sign of female congenital anomalies. Hysterectomy has been the mainstay treatment for many decades, due to the risk of reoperation. Advances in surgical technique of conservative treatment marked the overall success rate up to 60% with few cases are reported to have pregnancy.
Conclusions: Double approach technique could be a feasible option for conservative surgery in cervicovaginal agenesis.
References
1. Mikos T, Gordts S, Grimbizis GF. Current knowledge about the management of congenital cervical malformations: A literature review. Fertility and sterility. 2020;113:723-32. https://doi.org/10.1016/j.fertnstert.2020.02.006
2. 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. Congenital Anomalies. 2021;61:127-32. DOI: 10.1111/cga.12417
3. Suryawan AZ, Rachim W, Wenas M, Sukarsa MRA. Could we preserve reproductive function in complete vaginal agenesis and cervical agenesis? A case report and clinical perspective. SAGE Open Medical Case Reports. 2025;13:2050313X251324073. https://doi.org/10.1177/2050313X251324
4. Mikos T, Lantzanaki M, Anthoulakis C, Grimbizis GF. Functional and reproductive outcomes following surgical management of congenital anomalies of the cervix: A systematic review. Journal of Minimally Invasive Gynecology. 2021;28:1452-61. e16. DOI: 10.1016/j.jmig.2020.10.030
5. Grimbizis GF, Gordts S, Di Spiezio Sardo A, Brucker S, De Angelis C, Gergolet M, et al. The eshre/esge consensus on the classification of female genital tract congenital anomalies. Human reproduction. 2013;28:2032-44. https://doi.org/10.1093/humrep/det098
6. Kavita Khoiwal MS, Anchal Agarwal, Jaya Chaturvedi. The path of birth is not always normal: A case report of cervicovaginal agenesis. Gynecology and Minimally Invasive Therapy. 2021;10:247-51. DOI: 10.4103/GMIT.GMIT_57_20
7. Samantaray SR, Mohapatra I. Cervical dysgenesis: A rare mullerian duct anomaly. Cureus. 2021;13. https://doi: 10.7759/cureus.18279.
8. Song X, Zhu L, Ding J, Xu T, Lang J. Clinical characteristics of congenital cervical atresia and associated endometriosis among 96 patients. International Journal of Gynecology & Obstetrics. 2016;134:252-5. https://doi: 10.1016/j.ijgo.2016.02.015
9. E Passos IdMP, Britto RL. Diagnosis and treatment of müllerian malformations. Taiwanese Journal of Obstetrics and Gynecology. 2020;59:183-8. https://doi: 10.1016/j.tjog.2020.01.003.
10. Khoiwal KS, Meenakshi; Agarwal, Anchal; Chaturvedi, Jaya. The path of birth is not always normal: A case report of cervicovaginal agenesis. Gynecology and Minimally Invasive Therapy. 2021;10. https://doi: 10.4103/GMIT.GMIT_57_20
11. Catena U, Romito I, Moruzzi MC, De Blasis I, Testa AC, Scambia G. Successful conservative treatment in a rare case of type 2 congenital cervical dysgenesis: Case report and systematic literature review. Obstetr Gynecol Res. 2020;3:119-31.DOI: 10.26502/ogr036
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Tyas Priyatini, D. Irsat Syafardi
This work is licensed under a Creative Commons Attribution 4.0 International License.
