Keywords
Mullerian malformations
Pelvic pain
Amenorrhea
Vaginal agenesis
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Abstract
Objective: To analyze the main aspects of mullerian malformations, including etiopathogenesis, classification, diagnostic methods, and clinical and surgical approaches. Case details: Ninety-five patients with mullerian anomalies aged 10 to 44 years (median: 17 years) were evaluated. In 94 (98.9%), secondary sexual characteristics were normal for age; one patient had hypogonadism due to associated XX gonadal dysgenesis. The main complaints were primary amenorrhea (61.1%) and pelvic pain (52.6%), with 25.2% reporting both symptoms; 11.6% were asymptomatic. All were treated at a referral university hospital, with data recorded in medical charts. For diagnosis, 92 (96.8%) underwent pelvic ultrasound and 79 (83.2%) magnetic resonance imaging; 76 (80%) had both exams. The most prevalent diagnosis was Mayer-Rokitansky-Kuster-Hauser syndrome, identified in 27 patients (28.4%). Final considerations: Data indicate best practices from diagnosis to treatment. Self-dilation using the Frank technique is recommended for uterovaginal agenesis, though the ideal treatment remains controversial. In cases of menstrual obstruction, immediate surgical intervention is crucial to prevent complications, preserve fertility, and maintain quality of life.
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