Cervical fragmentation: a successful end-to-end anastomosis

Objective To report a case of cervical dysgenesis presenting with hematometra. Design Case report. Setting Teaching and research hospital. Patient(s) A 12-year-old girl presented with primary amenorrhea. At laparoscopic examination she was found to have a ball-shaped enlarged uterus without any type of connection to the upper normal-appearing cervix. Intervention(s) Conservative surgery with end-to-end anastomosis of the upper blunt end of the cervix to the lower part of the uterus was performed. Main Outcome Measure(s) Preserve fertility and/or maintain cyclic menstrual cycles. Result(s) After having normal menses for 3 months, the patient was admitted again with occlusion at the anastomosis site. Hematometra was drained and hysteroscopic and laparoscopic observations proved a normal-appearing uterus, endocervical canal, and cervix. Conclusion(s) Conservative surgical treatment with intact cervical and uterine segments, with an end-to-end cervicouterine anastomosis is a feasible and effective option in patients with cervical transverse fragmentation.