Distal vaginal agenesis (DVA) is a rare form of female genital tract malformation that presents as cryptomenorrhea. It results from the failure of the urogenital sinus to form the caudal portion of the vagina. Through a thorough history, physical examination and appropriate imaging studies, an accurate diagnosis is integral in selecting the correct intervention for the patient. This is a case of distal vaginal agenesis in a 10-year-old nulligravid, who presented with fecal retention from an abdominopelvic mass. The patient had no bowel movement for four days, and abdominal enlargement. On inspection, there was a 12.0cm x 10.0cm palpable abdominal mass. Inspection of the external genitalia, the introitus appeared concave, with no appreciable introital opening. On digital rectal examination, an anterior bulge was palpated 0.5 cm from the anal verge. A pull-through vaginoplasty was performed with an unremarkable post-operative course. The patient was discharged with a patent vagina and resolution of her gastrointestinal symptoms. On follow-up, the patient had monthly menstruation after surgery with no recurrence of her gastrointestinal symptoms.

Human ; Female ; Child: 6-12 Yrs Old ; Congenital Abnormalities ; Digital Rectal Examination ; Defecation

In Mayer-Rokitansky-K0ster-Hauser (MRKH) syndrome, the development of the uterus and some parts of the vagina is either completely absent or reduced. It is a rare congenital anomaly, and affects one in 4,000-5,000 female births and commonly presents as primary amenorrhea. Approximately 6% - 10% of these patients with MRKH syndrome report persistent pelvic pain, which may be attributed to the presence of myomas, endometriosis, adenomyosis or hematometra caused by a functioning endometrial tissue in a uterine remnant. This paper presents the case of a 37 year old nulligravid who experienced severe cyclic hypogastric pain, and was subsequently diagnosed with MRKH syndrome with adenomyosis. Clinical evaluation and definitive management of the index case are discussed.
Human ; Female ; Adult: 25-44 yrs old ; mullerian failure ; mullerian aplasia ; adenomyosis ; pelvin pain

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies among reproductive aged women. It is associated with metabolic problems such as obesity, insulin resistance and dyslipidemia. Obesity in itself is associated with insulin resistance and dyslipidemia. However, it remains unclear whether lean and obese PCOS women share the same metabolic profiles. Objective: The aim of this study was to identify the prevalence of abnormal glucose metabolism and dyslipidemia across different categories of body mass index among women with PCOS Methods: A retrospective cross – sectional study included 160 PCOS patients covering the years 2015 to 2017 was performed. Fisher’s exact test, one-way analysis of variance using Fisher-Hayter multiple comparisons procedure and independent-test were used to compare the prevalence of disease among the different categories of body mass index (i.e. non-obese, overweight and obese). Results: Among obese patients, the prevalence of pre-diabetes was 39.33% (35/89) and Type II diabetes mellitus was 8.99% (8/89). Among overweight, pre-diabetes patients were at 16.67% (5/30), while diabetics were only 6.67% (2). Among the non-obese population, only 17.07% (7/41) were classified as pre-diabetics while only 2.44% (1/41) were considered diabetic. For the prevalence of dyslipidemia, overweight and obese patients had the most proportion of affected individuals, at 90% (27/30) and 87.64% (78/89), respectively. Conclusion Abnormal glucose metabolism and dyslipidemia are more prevalent among obese and overweight women compared to non-obese PCOS patients.
Polycystic Ovary Syndrome ; Body Mass Index ; Insulin Resistance ; Dyslipidemias

This is a case report and review of the diagnosis and management of rudimentary horn pregnancy in a unicornuate uterus.
Human ; Female ; Young Adult ; PREGNANCY ; UTERUS