Successful Conservative Treatment in a Rare Case of Type 2 Congenital Cervical Dysgenesis: Case Report and Systematic Literature Review

Author(s): Ursula Catena, Ilaria Romito, Maria Cristina Moruzzi, Ilaria De Blasis, Antonia Carla Testa, Giovanni Scambia

Objective: Providing a systematic review of type 2 cervical dysgenesis (CD) by taking into consideration an interesting and rare case of genital anomaly which was treated with the use of laparoscopic ultrasound guidance.

Materials and Methods: A research of MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library was done. We analysed all types of study including case reports. We identified articles published at the time we began our review up from inception to July 2019.

Results: Three hundred thirty-four articles were identified, three hundred fifteen other articles were excluded for various reasons. Overall, nineteen articles were incorporated for further assessment. Three surgical techniques were used to treat type 2 cervical dysgenesis: drilling and coring technique (CDT), utero-vaginal anastomosis (UVA) and hysterectomy (HRT) or hemi-hysterectomy (H-HRT). Recurrences (38%) were described only with CDT. Five successful pregnancies were reported with the same technique.

Conclusions: Type 2 cervical dysgenesis is a rare congenital malformation. Data about recurrence and pregnancy rate are too sparse to recommend one technique rather than another. As shown in our comprehensive review, ultrasound-guided laparoscopy could represent a valid new surgical treatment approach.