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A Postconization Hematometra Revealed a Rare Case of Endocervical Bone Metaplasia

Giannella, Luca MD1,2; Gelli, Maria Carolina MD3; Mfuta, Kabala MD1,2; Prandi, Sonia MD2

Journal of Lower Genital Tract Disease: January 2014 - Volume 18 - Issue 1 - p E19–E22
doi: 10.1097/LGT.0b013e3182914eef
Original Articles

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:

The authors have declared they have no conflicts of interest.

Copyright © 2014 by the American Society for Colposcopy and Cervical Pathology