Health problems related to female genital malformations: Obstructive and complex anomalies

Abstract

The main objective was to evaluate health problems like cyclic pelvic pain, hematocavity and hematometra, as well as potentially dangerous complications like “topic” horn pregnancies in obstructive and complex female genital tract malformations.Primary amenorrhea and cyclic pelvic pain are the main presenting symptoms when these patients reach puberty. Teenage girls, who have any obstruction to menstrual flow, may present hematocolpos or hematometra and are at increased risk for endometriosis. Class U4a hemi-uterus is susceptible to gynecologic and obstetric complications, while the incidence of ectopic pregnancy is as high as 22 % and therefore laparoscopic removal of the rudimentary horn and its tube is indicated when this uterine anomaly is diagnosed. The incidence of renal abnormalities in patients presenting with Mullerian anomalies is approximately 30 % and this has certainly clinical implications not only concerning symptomatology, but also for scheduling complex multidisciplinary surgical interventions. These individuals present quite frequently emotional trauma, anxiety and even depression and psychologic support and counseling is therefore recommended.Restoration management of the non-communicating horn should be an open issue for further research. The involvement of a multi-disciplinary team for the pre-operative management, surgical approach and follow-up is of utmost importance for the lege artis approach of these patients and centralization of cervices will ensure these individuals receive holistic and high quality medical care.