Laparoscopic Evaluation of Anatomical Uterovaginal (Müllerian )Duct Anomalies and associated Ovarian Anomalies in Amenorrheic patients

Ishak Shaaya, Elias; Jasim Al-Husaynei, Ahmed; Ibraim Khalel Al-Allaf, Luma

	Laparoscopic Evaluation of Anatomical Uterovaginal (Müllerian )Duct Anomalies and associated Ovarian Anomalies in Amenorrheic patients
Medical Journal of Tikrit
Article 1, Volume 1, Issue 161, 2012, Pages 46-55
Authors
Elias Ishak Shaaya; Ahmed Jasim Al-Husaynei; Luma Ibraim Khalel Al-Allaf
Abstract
Failure or incomplete fusion of the paired uterovaginal (Müllerian)ducts accompanied with a spectrum of uterine ,cervical ,and vaginal anomalies which are accompanied by obstruction and leading to amenorrhea. The complex anatomy of ovaries and Müllerian ducts require complete evaluation before treatment. This study aims to determine the frequencies of uterovaginal anomalies and that of ovarian anomalies in group of women presented with primary amenorrhea and to determine whether these Müllerian anomalies are associated with the ovarian anomalies in those patients. In addition this study aims to identify the more frequent ovarian anomaly which was associated with uterovaginal anomalies in a group of patients presented with primary amenorrhea. Al-Batool Maternity Teaching hospital in Mosul city in Northern Iraq. This study was conducted over a period of 4 months started from 1st June 2008 to 1st October 2008.The data were collected from the medical reports of 82 women presented with history of primary amenorrhea during the years 2000-2008.Those women who attended to the hospital and in whom a laparoscopy was performed at Al-Batool Maternity Teaching hospital in order to evaluate the morphology of their ovaries ,and uteruses .Gonadal agenesis /dysgenesis was shown in twenty eight(34.1%) out of 82 women presented with amenorrhea, while forty five (54,8%)women had different uterovaginal anomalies. Four (4.8%) women had no uterus, while rudimentary uterus was shown in the reports of six(7.3%) cases. Ten (12.1%) women had infantile uterus, while absent uterus and upper vagina was shown in eight(9.7%) women ,and one case of aplasia in her uterus and cervix was reported .On the other hand twelve(14.6%) cases had a vaginal transverse vaginal septum and or an imperforated hymen. Eighteen cases(40.0%)out of 45 cases of anatomical uterovaginal anomalies were accompanied with ovarian abnormalities ,the laparoscopic reports of five(11.1%) women revealed combined Müllerian agenesis and absent one or both ovaries, while absent uterus and ovaries were shown in one case(2.2%).Nine (20.0%)women had got infantile uterus and bilateral streak ovaries. On the other hand unilateral ovarian and tubal agenesis was shown in one (2.2%) woman. Two (4.4%) cases of polycystic ovaries were accompanied with uterine anomalies one of them was a case of polycystic ovaries and rudimentary uterus while the another case of polycystic ovaries was accompanied with septate uterus. The presence of testis instead of uterus and ovaries was reported in the pelvis of one case (1.2%).Six (13.3%) out of 45 cases of uterovaginal anomalies was associated with ovarian agenesis , while nine(20.0%) out of 45 cases of uterovaginal anomalies was associated with ovarian dysgenesis The gonadal agenesis was the first cause of the primary amenorrhea, while the transverse vaginal septum was the second cause .The study concluded that the frequency of anatomical uterovaginal anomalies which are not associated with ovarian anomalies was higher than that accompanied with ovarian anomalies. Ovarian dysgenesis was the most frequent ovarian anomaly which was accompanied with uterovaginal anomalies.
Keywords
Laparoscopic Evaluation of Anatomical Uterovaginal; Amenorrheic

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