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Vaginal adhesions in a woman with the history of dystocia.

Kim HM, Bae JY, Cho YJ, Kim MJ, Cha HH, Cha HW, Seong WJ - Obstet Gynecol Sci (2014)

Bottom Line: Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months.Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum.The patient was successfully treated with surgical resection and administration of antibiotics.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Kyungpook University School of Medicine, Daegu, Korea.

ABSTRACT
Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months. Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum. The patient was successfully treated with surgical resection and administration of antibiotics.

No MeSH data available.


Related in: MedlinePlus

The septal wall was excised, a window was made, and the remnant edge was sutured to the vaginal sidewall in all directions using interrupted 2-0 Vicryl suture.
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Figure 2: The septal wall was excised, a window was made, and the remnant edge was sutured to the vaginal sidewall in all directions using interrupted 2-0 Vicryl suture.

Mentions: After hospitalization, prophylactic intravenous antibiotics (3rd-generation cephalosporin with metronidazole) were administered first. After the day of admission, the fluid in the obstructed vaginal cavity was aspirated and examined. This fluid was turbid and had a foul odor but no bacteria were found upon culture examination. With this aspiration, we excised the vaginal septum and sutured the remained edge of this septum to the vaginal wall using 2-0 Vicryl (Ethicon Inc., Somerville, NJ, USA) (Fig. 2). After the operation, we inserted Vaseline gauze into the vaginal cavity to prevent re-adhesion and hemorrhage. This packed gauze was maintained during the whole hospitalization period and changed every day. Antibiotics were administered intravenously for 5 days and she was discharged on day 5 after the operation. Three months following surgery, she noticed an improvement in her dyspareunia and resumed sexual activity. Pelvic examination revealed a well-maintained vaginal cavity.


Vaginal adhesions in a woman with the history of dystocia.

Kim HM, Bae JY, Cho YJ, Kim MJ, Cha HH, Cha HW, Seong WJ - Obstet Gynecol Sci (2014)

The septal wall was excised, a window was made, and the remnant edge was sutured to the vaginal sidewall in all directions using interrupted 2-0 Vicryl suture.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924740&req=5

Figure 2: The septal wall was excised, a window was made, and the remnant edge was sutured to the vaginal sidewall in all directions using interrupted 2-0 Vicryl suture.
Mentions: After hospitalization, prophylactic intravenous antibiotics (3rd-generation cephalosporin with metronidazole) were administered first. After the day of admission, the fluid in the obstructed vaginal cavity was aspirated and examined. This fluid was turbid and had a foul odor but no bacteria were found upon culture examination. With this aspiration, we excised the vaginal septum and sutured the remained edge of this septum to the vaginal wall using 2-0 Vicryl (Ethicon Inc., Somerville, NJ, USA) (Fig. 2). After the operation, we inserted Vaseline gauze into the vaginal cavity to prevent re-adhesion and hemorrhage. This packed gauze was maintained during the whole hospitalization period and changed every day. Antibiotics were administered intravenously for 5 days and she was discharged on day 5 after the operation. Three months following surgery, she noticed an improvement in her dyspareunia and resumed sexual activity. Pelvic examination revealed a well-maintained vaginal cavity.

Bottom Line: Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months.Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum.The patient was successfully treated with surgical resection and administration of antibiotics.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Kyungpook National University Hospital, Kyungpook University School of Medicine, Daegu, Korea.

ABSTRACT
Postpartum genital tract adhesions are unusual, and their cause has not been evaluated. However, severe dystocia and numerous pelvic examinations have been suggested as possible causes. Here, we report a case of vaginal adhesions following a difficult labor that presented as dyspareunia for 5 months. Pelvic examination and ultrasonography revealed a transverse vaginal septum that obstructed the vaginal cavity, and fluid collection proximal to this septum. The patient was successfully treated with surgical resection and administration of antibiotics.

No MeSH data available.


Related in: MedlinePlus