Background: Hematometra is an unusual occurrence in young women undergoing conization; moreover, osseous metaplasia of the uterine cervix is a very rare event, with 7 cases in the literature. A postconization hematometra due to endocervical ossification is a unique occurrence. The authors report such an event.
Case: A young woman undergoing conization developed progressive hypoamenorrhea with pelvic pain. Pregnancy test was negative and a transvaginal ultrasound showed an image of suspected hematometra. Diagnostic hysteroscopy showed an endocervical obstruction due to a bone formation of the uterine cervix, which was removed with an office operative hysteroscopy. After surgery, the patient restored normal menstrual cycle. Histological examination revealed a cervical bone metaplasia.
Conclusions: In premenopausal women undergoing conization, the appearance of a progressive hypoamenorrhea with pelvic pain could suggest a cervical mechanical obstruction that could be an uncommon stenosis. Despite this case represents a very rare event, a postconization hematometra due to an endocervical ossification can be managed with an office operative hysteroscopy.
In premenopausal women, a postconization hematometra may be due to an endocervical ossification that can be managed with an office operative hysteroscopy.
1Division of Obstetrics and Gynecology, Cesare Magati Hospital, Scandiano; 2Cervical Cancer Screening Centre, and 3Department of Pathology, IRCCS- Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
Reprint requests to: Luca Giannella, MD, Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Viale Martiri della Libertà 6, 42019, Scandiano, Reggio Emilia, Italy. E-mail: firstname.lastname@example.org
The authors have declared they have no conflicts of interest.