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Müllerian Malformations andTheir Treatments

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Amenorrhea

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Abstract

Müllerian malformations (MM) are the anomalies resulting from failure of fusion of the paramesonephric ducts in the middle line, during their connection with the urogenital sinus. They occur due to alterations in the formation of the upper vaginal lumen and the uterine lumen, and also because of non-absorption of the septum in the fusion of ducts. The prevalence of congenital uterine anomalies in unselected populations is 5.5%, while in infertile patients is 8.0%. The two principal classifications used currently, that of AFS-ASRM and of ESHRE/ESGE, encompass the majority of cases, although there are others and there is still not a consensus. There are isolated cases of MM that do not fit into any of the classifications. Clinical examination has a major role in diagnosis, although US2D is the first imaging exam used, followed by MRI, which for some authors is the gold standard imaging exam. Malformations that obstruct the menstrual flow should be treated rapidly doing a suitable surgical procedure for each case. Patients with vaginal agenesis may undergo vaginoplasty or vaginal dilatation through diverse techniques. Technologic advances in surgical equipment, as well as laparoscopy, have helped in better correction of these anomalies. Correction of MM should be based not only on patient’s symptom relief, but also on a girl’s future fertility consideration.

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Abbreviations

MM:

Müllerian malformations

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Authors and Affiliations

  1. Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Efthymios Deligeoroglou

  2. Division of Pediatric-Adolescent Gynecology, MITERA Children’s Hospital, Athens, Greece

    Efthymios Deligeoroglou & Vasileios Karountzos

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  1. Efthymios Deligeoroglou
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  2. Vasileios Karountzos
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Editors and Affiliations

  1. International Society of Gynecological Endocrinology, Pisa, Italy

    Andrea R. Genazzani

  2. Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden

    Angelica Lindén Hirschberg

  3. Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, MODENA, Modena, Italy

    Alessandro D. Genazzani

  4. Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Pavia, Italy

    Rossella Nappi

  5. Faculty of Medicine Clinic of Endocrinology Diabetes and Diseases of Metabolism, University of Belgrade University Clinical Center of Serbia, Belgrade, Serbia

    Svetlana Vujovic

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Deligeoroglou, E., Karountzos, V. (2023). Müllerian Malformations andTheir Treatments. In: Genazzani, A.R., Hirschberg, A.L., Genazzani, A.D., Nappi, R., Vujovic, S. (eds) Amenorrhea. ISGE Series. Springer, Cham. https://doi.org/10.1007/978-3-031-22378-5_1

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