Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature
Abdel Hamid, A., Fawzy el Hao, M., Abdel Hamid, S. (2023). Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature. EKB Journal Management System, 27(6), 10-16. doi: 10.21608/egyfs.2023.333772
Ahmed Sherif Abdel Hamid; Mounir Mohamed Fawzy el Hao; Suzy Abdelaziz Abdel Hamid. "Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature". EKB Journal Management System, 27, 6, 2023, 10-16. doi: 10.21608/egyfs.2023.333772
Abdel Hamid, A., Fawzy el Hao, M., Abdel Hamid, S. (2023). 'Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature', EKB Journal Management System, 27(6), pp. 10-16. doi: 10.21608/egyfs.2023.333772
Abdel Hamid, A., Fawzy el Hao, M., Abdel Hamid, S. Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature. EKB Journal Management System, 2023; 27(6): 10-16. doi: 10.21608/egyfs.2023.333772

Distal vaginal atresia presented with apareunia with regular menses and not primary amenorrhea diagnosed by 3D ultrasound and managed by vaginal pull-through aided by 3D ultrasound: A case report and review of literature

The Egyptian Journal of Fertility of Sterility
Article 3, Volume 27, Issue 6 - Serial Number 11106352, November 2023, Page 10-16  XML PDF (2.74 MB)
Document Type: Original Article
DOI: 10.21608/egyfs.2023.333772
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Authors
Ahmed Sherif Abdel Hamid email orcid 1; Mounir Mohamed Fawzy el Hao2, 3; Suzy Abdelaziz Abdel Hamid4, 5
1Assistant prof of Obstetrics and Gynecology Faculty of medicine, Ain Shams University, Cairo-Egypt
2Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt
3Professor of Obstetrics & Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
4Assistant Professor of Obstetrics & Gynecology, Faculty of Medicine, Cairo University Cairo, Egypt
5Department of Obstetrics and Gynecology, Cairo University, Cairo, Egypt
Abstract
Introduction: We report a rare case of distal vaginal atresia not presented by primary amenorrhea but with the inability to have the first sexual intercourse after marriage. 
Case: The patient had normal menarche and regular cycles. Thus, the challenge was in diagnosing such cases with vaginal atresia with normal menses. The menstrual flow was small in amount. The complaint came after her marriage when her husband felt strong resistance. On examination, no vaginal opening was observed. When examined again during menses, a very small opening was observed, from which the menses flow was discharged: it admitted only a pediatric Foley catheter (denoting a small fistulous tract). 3D ultrasound revealed complete uterus, cervix, and vaginal pouch development. Vaginal atresia was identified: an operation was done under a 3D rectal ultrasound guide to identifying the dissection plane. Perineal dissection was done, and pull-through of the vaginal pouch, then suturing the lower end of the vagina to the perineum.
Conclusion: not all cases of vaginal atresia cause primary amenorrhea but may present later with sexual problems. 3D rectal ultrasound is an excellent aid in diagnosis and treatment aid.

Keywords
Keywords: Apareunia; Ultrasound; Distal vaginal atresia
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