Hysteroscopic management of cervicovaginal adhesions presenting as long-term sequelae of vulvovaginal graft-versus-host disease

BackgroundVulvovaginal graft-versus-host disease (GVHD) is an underdiagnosed and poorly recognized complication of HSCT1,2. We aim to present hysteroscopic management cervicovaginal dense adhesions developed as a long-term sequelae vulvovaginal GVHD in 16-years-old girl who has Diamond-Blackfan Anemia. The institutional review board approval was obtained.CaseA presented with pelvic pain for last 2 months. Her previous history significant anemia having HSCT 10 years ago. She started on pubertal induction 3 ago she had been receiving E2 replacement cyclic progesterone the 6 months without any menstrual bleeding. Perineal inspection revealed absence external vaginal opening. Abdominal ultrasonography relatively small uterus thin endometrial lining some fluid collections cervical canal vagina. topical steroid dilation were tried first. Since adequate patency could not be achieved, lysis performed under general anesthesia.ConclusionThe possible late effects genital organs should remembered, since adolescents may underreport symptoms1-3. Office hysteroscopy method that can used safely opening synechia patient GVHD. Vulvovaginal obtained. A anesthesia.