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Symptoms of malformations of the vagina and uterus
Last reviewed: 23.04.2024
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In the pubertal period, vaginal and uterine malformations are manifested, in which primary amenorrhea and / or pain syndrome are observed: vaginal and uterine aplasia, hymen atresia, aplasia of the whole or part of the vagina with the functioning uterus.
In girls with aplasia of the vagina and uterus, a characteristic complaint is the absence of menstruation, in the future - the impossibility of sexual activity. In some cases, in the presence of a functioning rudimentary uterus from one or both sides in the small pelvis, cyclic pain in the abdomen may occur.
Patients with atresia of the hymen at puberty age complain of cyclical pains, a feeling of heaviness in the lower abdomen, sometimes difficulty in urinating. In the literature, there are many examples of violations of the function of neighboring organs in girls with atemia of the hymen and the formation of large hematocolpos. R. Chircop (2003) observed an acute retention of urination in a 13-year-old girl with hematocolpos and hematoma. Arising at the atemia of the hymen. A. Kumar (2002) describes the retention of urination on the background of intense pain in the lower abdomen in two girls with atemia of the hymen. RG Buick (1999) reported a girl with atemia of the hymen, complaining of pain in the lumbar region, urinary incontinence and constipation lasting for 72 hours.
A typical complaint of patients with aplasia of part of the vagina with a functioning uterus is the presence of cyclic (every 3-4 weeks) pains in the lower abdomen (with hematocolposis - aching, with a hematometer - cramping), may be vomiting, fever, rapid, painful urination. Violation of defecation.
When doubling the vagina and uterus with partial aplasia of one of the vaginas and an additional functioning horn of the uterus, sharply painful menstruation is characteristic. In this defect, the outflow of menstrual blood from one of the vaginas is broken, which is partially aplazirovana (blindly closed) at the level of its upper, middle or lower third. Patients are concerned about the monthly repeated severe pains in the lower abdomen, which are not stopped by analgesics or antispasmodics, leading them to suicidal attempts. When the fistula between the vaginas forms, permanent blood or purulent discharge from the genital tract appears in the patients.
Vices such as complete doubling of the uterus and vagina, bicornic uterus, intrauterine partition (complete or incomplete), may not be clinically apparent. Sometimes patients notice painful and / or profuse menstruation.
Patients with rudimentary closed horn of the uterus complain of severe pains in the lower abdomen, occurring soon after menarche, increasing with each menses, which are not stopped by antispasmodics and analgesics. The intensity of pain and inefficiency of therapy causes suicidal thoughts in them, and sometimes attempts to commit suicide. The rudimentary uterus (not having a neck) can be attached to the main uterus, and also intimately connected to it without communicating the cavities of these queens to each other. In this situation, in the presence of a functioning endometrium, there is a violation of the outflow of menstrual blood from the cavity of the rudimentary uterus (horn), which, accumulating in it, leads to the formation of hematomas and a hematosalpinx on the rudimentary side.
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