Wharton-Sheares-George vaginoplasty for Müllerian agenesis: A case report

Abstract

Abstract

Background: Müllerian agenesis is a rare embryological disorder that affects 1 in 4500-5000 female livebirths. It may result in anomalies of the uterus, vagina, or both necessitating surgical management.

Case presentation: A 23-year-old nulliparous presented to the gynecological ward with amenorrhea, severe lower abdominal pain, and bloating. Physical examination revealed well-developed breasts in Tanner stage v. The vagina was noted as a blind-ending dimple with a patent urethral opening. Pelvic magnetic resonance imaging revealed hematometra in the rudimentary right uterine horn. She was scheduled for diagnostic laparoscopy and Wharton-Sheares-George vaginoplasty. A review four weeks later revealed vaginal stenosis, which was managed laparoscopically, with the excision of the rudimentary uterine horn. Her postoperative recovery was uneventful. Her external genitalia were normal, and the vaginal mucosa was typical, with a depth of 6cm and she is currently using Syracuse vaginal dilators and on long-term follow-up.

Conclusion: Wharton-Sheares-George vaginoplasty is a minimally invasive, quick, reliable, and safe procedure for patients with Müllerian agenesis requiring vaginoplasty