An 18-year-old patient, primary amenorrhea, was referred with the diagnosis of suspected Rokitansky Syndrome, when a month before she had been seen in the emergency service for tearing sexual intercourse after introitus.
The examination revealed the following: the labia majora and minora are normal in appearance and size for their age, have a small vaginal introitus and complete absence of the rest of the vagina.
The clinical study is completed with the following presentations.
Gynecologic cytology: absence of cellular atypia; Gynecologic bacteriology: small and scarce Döderlein bacilli; Hormonal study: normal; Karyotype: XX; Urography: right renal agenesis and gynecological diameter 2.8 cm
The left annex was 2.6 cm in diameter.
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Preoperative studies were performed and the patient underwent general anesthesia. A neovagina is removed between the urethra and the rectum, resulting in a partial skin graft taken from the right thigh.
In the postoperative revisions carried out during six years, nothing abnormal was found in the neovagina and as the only remarkable data it is worth mentioning the metaplasia of the skin of the neovagina close to the vulvar introituitary.
After that time, he came to the hospital because of a bad vaginal discharge.
The patient reported having had several sexual contacts with the same person two months before the onset of symptoms.
Gynecologic examination revealed vulvar introitus and congested minor lips, with a exudate of dry consistency and a white coloration with a neovagina.
In the neovagina the exudate became thicker, was bad smell and its color was not uniform (white-yellowish red).
In the proximal (upper) half of the neovagina, adhered to the skin of its lateral faces and of the bottom of the bag or vaginal dome, there was a mass with a proliferative aspect of cauliflower, formed by innum
Proliferation and exudate samples were taken and the results were the following.
Bacterial culture: Usual flora; Anatomopathological study: polystratified plane epithelium with secanthic and parakeratosis.
The cells frequently presented clear cytoplasms of the cotylocytic type and slightly enlarged and polymorphic nuclei; Anatomopathological diagnosis: HPV condyloma (positive by in situ hybridization).
After the local and general medical treatment, lesions were not cleaned with antiretroviral therapy (400 mgr/h for 10 days) and topical application every 4 hours during the same time, followed by application every 6 hours for one month (restings).
