Outflow tract disorder of the female genital tract TOG 2013

Question 1

Picture explaining development of female reproductive tract

Answer 1

Question 2

Pictures explain unicornuate, didelphus, bicorunaye, septate, arcuate

Answer 2

Question 3

How common is congenital anomalies of genital tract?

Answer 3

2-4% most abnormality of uterine fusion - 90% septate uterine

Question 4

How common is MRKH syndrome

Answer 4

1:5000 female birth, 1:10000 population

Question 5

How does MRKH present?

Answer 5

Primary amenorrhoea with normal secondary sexual characteristics
Absence of uterus and vagina
40% all have renal tract abnormality (12% absent kidney)
3% hearing loss

Question 6

Presentation imperforate hymen

Answer 6

Large mass - may be palpable abdominally, may effect micturation/defaecation
Vuval - blue me,nreane

Tx Cruciate invision

Thin mambrane function sinovaginal bulb with urogenital sinus

Question 7

Transverse vaginal septum - where is most common

Answer 7

Upper 46%
Mid 30-40%
Lower 15-20%

uncommon 1:50000

Question 8

How does transverse vaginal septum present

Answer 8

Cyclical pain, amenorrhoea
Palpable mass

Surgical resection, mould and vaginal dilators

Question 9

Rate of pregnancy based on location of septum

Answer 9

Upper 1/3 20%
Mid 40%
Lower 100%

Question 10

What is this?

Answer 10

Longitundinal vaginal septum
A) high
B) Low

Question 11

Which uterine anomaly can cause haemaometra?

Answer 11

Unicornate uterus with rudimentary horn

Question 12

What is this?

Answer 12

MRI haemtocolpos

Imaging can be performed by USS or MRI

Question 13

Which conditions should be managed by a tertiary centre?

Answer 13

Absent vagina, transverse vaginal septum, absent cervix, rudimentary horn - depending on secondary local expertise