Amber R Cooper1, Diane F Merritt. 1. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Washington University, St. Louis School of Medicine, 4444 Forest Park Avenue, Suite 3100, St. Louis, Missouri 63108, USA. coopera@wudosis.wustl.edu
Abstract
OBJECTIVE: To describe a novel use for a tracheobronchial stent to maintain patency after vaginal septum excision in a patient with an obstructed hemivagina and uterine didelphys. DESIGN: Description of a novel technique. SETTING: University-affiliated children's hospital. PATIENT(S): One patient with an obstructed hemivagina and uterine didelphys who presented with hematometria and hematocolpos. INTERVENTION(S): To maintain patency and decrease stenosis risk after vaginal septum excision, a coated tracheobronchial stent was deployed and left in place for 6 weeks. MAIN OUTCOME MEASURE(S): To evaluate ease of stent placement and removal, reepithelialization and patency of the neovagina, and postoperative assessment of pain and recurrent obstruction. RESULT(S): The tracheobronchial stent was easily positioned and deployed with vaginoscopic guidance. Six weeks later it was removed without any tissue ingrowth or granulation tissue noted. The vaginal walls were nicely epithelialized. Twelve months postoperatively, the patient remained pain free with regular cycles and no evidence of obstruction or abnormality on ultrasound. CONCLUSION(S): Use of a coated tracheobronchial stent to maintain patency after septum excision in a patient with an obstructed hemivagina presents a safe, easy, and effective option to diminish stenosis risk and avoid infectious complications or hysterectomy. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
OBJECTIVE: To describe a novel use for a tracheobronchial stent to maintain patency after vaginal septum excision in a patient with an obstructed hemivagina and uterine didelphys. DESIGN: Description of a novel technique. SETTING: University-affiliated children's hospital. PATIENT(S): One patient with an obstructed hemivagina and uterine didelphys who presented with hematometria and hematocolpos. INTERVENTION(S): To maintain patency and decrease stenosis risk after vaginal septum excision, a coated tracheobronchial stent was deployed and left in place for 6 weeks. MAIN OUTCOME MEASURE(S): To evaluate ease of stent placement and removal, reepithelialization and patency of the neovagina, and postoperative assessment of pain and recurrent obstruction. RESULT(S): The tracheobronchial stent was easily positioned and deployed with vaginoscopic guidance. Six weeks later it was removed without any tissue ingrowth or granulation tissue noted. The vaginal walls were nicely epithelialized. Twelve months postoperatively, the patient remained pain free with regular cycles and no evidence of obstruction or abnormality on ultrasound. CONCLUSION(S): Use of a coated tracheobronchial stent to maintain patency after septum excision in a patient with an obstructed hemivagina presents a safe, easy, and effective option to diminish stenosis risk and avoid infectious complications or hysterectomy. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.