Obstet Gynecol Sci.  2016 Nov;59(6):559-561. 10.5468/ogs.2016.59.6.559.

Complete vaginal outlet stenosis in a patient with Sheehan’s syndrome

• Choo M
• Park H
• Yi KW

• KMID: 2378585
• DOI: http://doi.org/10.5468/ogs.2016.59.6.559

Abstract

We present a case of complete vaginal stenosis in a woman diagnosed with Sheehan's syndrome. The patient delivered at full-term 5 months prior, and experienced massive postpartum bleeding at that time. During evaluation of persistent amenorrhea, we found that her vaginal orifice was completely adhesive and obstructed. Prior to corrective surgery, we managed the patient with an oral contraceptive to induce uterine bleeding into the vaginal outflow tract. After three cycles of an oral contraceptive, we could confirm that there was no stenotic lesion in the vaginal cavity as a hematocolpos was created. Adhesiolysis with scar revision for the vaginal stenosis was successfully performed; it was found that the lesion was limited to only the distal part of the vaginal outlet. Complete vaginal stenosis in reproductive age women with hypopituitarism has not been reported. The artificial induction of hematometrocolpos before surgery was useful in determining the extent of the stenotic lesion, and assured safety.

Keyword

Hematocolpos; Hypopituitarism; Vaginal stenosis

MeSH Terms

Adhesives
Amenorrhea
Cicatrix
Constriction, Pathologic*
Female
Hematocolpos
Hemorrhage
Humans
Hypopituitarism
Postpartum Period
Uterine Hemorrhage
Adhesives

Figure

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  Fig. 1 Marked decreased pituitary gland (arrow) suggesting for atrophy on magnetic resonance imaging (T1 sagittal view).

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  Fig. 2 Trans abdominal sonography showed a hematocolpos anterior to the uterus (UT) and measuring 84×66 mm containing echogenic fluid and corresponding to a distended vagina.

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