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Study Question: What is the recommended diagnostic work-up of female genital anomalies according to the European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) system?Summary Answer: The ESHRE/ESGE consensus for the diagnosis of female genital anomalies is presented.What Is Known Already: Accurate diagnosis of congenital anomalies still remains a clinical challenge because of the drawbacks of the previous classification systems and the non-systematic use of diagnostic methods with varying accuracy, some of them quite inaccurate. Currently, a wide range of non-invasive diagnostic procedures are available enriching the opportunity to accurately detect the anatomical status of the female genital tract, as well as a new objective and comprehensive classification system with well-described classes and sub-classes.Study Design, Size, Duration: The ESHRE/ESGE CONgenital UTerine Anomalies (CONUTA) Working Group established an initiative with the goal of developing a consensus for the diagnosis of female genital anomalies. The CONUTA working group and imaging experts in the field have been appointed to run the project.Participants/materials, Setting, Methods: The consensus is developed based on: (i) evaluation of the currently available diagnostic methods and, more specifically, of their characteristics with the use of the experts panel consensus method and of their diagnostic accuracy by performing a systematic review of evidence and (ii) consensus for the definition of where and how to measure uterine wall thickness and the recommendations for the diagnostic work-up of female genital anomalies, based on the results of the previous evaluation procedure, with the use of the experts panel consensus method.Main Results and the Role Of Chance: Uterine wall thickness is defined as the distance between the interostial line and external uterine profile at the midcoronal plane of the uterus; alternatively, if a coronal plane is not available, the mean anterior and posterior uterine wall thickness at the longitudinal plane could be used. Gynecological examination and two-dimensional ultrasound (2D US) are recommended for the evaluation of asymptomatic women. Three-dimensional (3D) US is recommended for the diagnosis of female genital anomalies in 'symptomatic' patients belonging to high risk groups for the presence of a female genital anomaly and in any asymptomatic woman suspected to have an anomaly from routine evaluation. Magnetic resonance imaging (MRI) and endoscopic evaluation are recommended for the subgroup of patients with suspected complex anomalies or in diagnostic dilemmas. Adolescents with symptoms suggestive for the presence of a female genital anomaly should be thoroughly evaluated with 2D US, 3D US, MRI and endoscopically.Limitations, Reasons For Caution: The various diagnostic methods should always be used in the proper way and evaluated by experts to avoid mis-, over- and underdiagnosis.Wider Implications Of the Findings: The role of a combined US examination and outpatient hysteroscopy should be prospectively evaluated. It is a challenge for further research, based on diagnosis, to objectively evaluate the clinical consequences related to various degrees of uterine deformity.Study Funding/competing Interests: None. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To present the first repeat procedure and a simple way for management of balloon rupture during balloon vaginoplasty (BV) procedures. Study design: Repeat BV (reBV) procedure was done for one case, and a ruptured catheter''s end to new catheter''s end (ENE) procedure was done for two cases. The anatomic and functional outcomes of reBV and ENE are presented. Results: Balloon rupture and deflation were encountered in a total of 3/45 cases who had undergone BV procedures. Replacement time was 22min for reBV, and 9 and 10min for ENE. General anesthesia was needed in the reBV case. Post-operative course and final outcomes were generally good but objectively less favorable in the ENE than in the reBV case (neovaginal depths were 8.5 and 9.4cm versus 11cm, respectively). Penetration and satisfaction scores were increased up 85 points for both couples. Conclusions: Balloon ruptures were reported in 3/45 cases undergoing balloon vaginoplasty. End to new catheter end replacement was a very fast and simple rescue procedure but its preliminary anatomical outcomes were less favorable than the outcomes obtained with the original or repeat procedure. [Copyright &y& Elsevier]

We evaluated the feasibility and operative and postoperative outcomes of office balloon vaginoplasty. Office balloon vaginoplasty was performed successfully for a case with vaginal aplasia. She was currently married and presenting with minimal penetration and dyspareunia. We successfully performed the procedure through retro-pubic space under local anesthesia within 25 min total operative time and it was well tolerated by the patient. No operative complications were reported. The resulting neovagina was cosmetically attractive and 10 cm in depth. Sexual intercourse was started on the day of catheter removal. Penetration and satisfaction scores increased up to 90 points for both partners. [ABSTRACT FROM AUTHOR]