Diagnosis and management of congenital anomalies of the female genital tract in pediatric age

Congenital malformations of the female genital tract includes various forms of deviations from normal anatomy that arise from embryological abnormal development of the Paramesonephric or Mullerian ducts with an incidence of 4–7 %. The Herlyn–Werner–Wunderlich syndrome (OHVIRA) is a form of Mullerian duct anomalies consisting of hemivaginal septum and duplicated uterus with ipsilateral renal agenesis. The article describes cases of congenitalanomalies of the female genital tract in adolescents observed in 2024 in the healthcare institution “1st City Clinical Hospital”, Minsk Belarus.

Methods. There were eight patients with congenital anomalies of female genital tract in the study period: 4 adolescence with OHVIRA syndrome and 4 patients with transverse vaginal septum and imperforate hymen. The authors present their experience in the management of pediatric patients with congenital anomalies of female genital tract focusing on the clinical course, diagnostic findings and treatment options.

Results. The mean age of patients was 11 years (10 years–14 years). The most common presenting sign was pain due to obstruction, causing difficulties in the passage of menstrual flow with hematocolpos formation. Surgical treatment was performed in 7 cases of complete obstruction with transvaginal septoplasty and drainage of the hematocolpos and hematometra, but one patient with OHVIRA syndrome required further laparoscopy with salpingectomy for pelvic inflammatory complications related to obstructed hemivagina.

Conclusion. Due to the association of female genital tract anomalies with renal anomalies we recommend that girls with identified renal malformations should be screened for the presence of female genital tract anomalies.

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