Geburtshilfe Frauenheilkd 2006; 66 - PO_K_03_04
DOI: 10.1055/s-2006-952615

Therapy of recurrent hematometra caused by cervical stenosis after laser-conization using a coated nitinol-stent

D Grund 1, C Koehler 1, H Krauel 2, A Schneider 3
  • 1Klinik für Gynäkologie, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin
  • 2Helios Klinikum Weißensee- Klinik für Innere Medizin, Weißensee- Hohenmölsen
  • 3Universitätsmedizin Berlin, Charité, Berlin

Background:

The incidence of hematometra due to cervical stenosis after conization is less than 1%. Nevertheless, if dilatation fails further therapy often remains unclear. The clinical consequences can be severe, including hysterectomy.

Case:

We report the case of a 33-year old patient who had two conizations during lactation amenorrhoea because of an adenocarcinoma in situ of the cervix. This lead to recurrent cervical stenosis with consecutive hematometra every month. The stenosis could not be sufficiently treated by repeated dilatation and insertion of a temporary plastic catheter (Fehling-catheter). With the application of a coated nitinol-stent in the cervical canal after dilatation and hysteroscopic removal of the hematometra the patient has been free of symptoms with a normal menstruation for 8 months.

Conclusion:

The insertion of a coated vessel stent in the uterine cervix seems to be a valid alternative in patients with recurrent cervical stenosis and hematometra following conization in order to preserve childbearing function.