Innovative abdominoperineal surgery for fertility-preserving cervicovaginal reconstruction in five patients with the rare condition of congenital cervical malformation coexisting with vaginal atresia.

This retrospective case series of five adolescents (mean age 14.2 years) with congenital cervical malformation and vaginal atresia asks whether a laparoscopic abdominoperineal reconstruction can restore menstrual outflow while preserving fertility. All patients underwent the procedure, which used uterine artery branch preservation, partial cervical preservation, pelvic peritoneal coverage, and a custom T-shaped utero-vaginal stent, with no intraoperative complications and normal menses resuming within a month. Over a mean follow-up of about 24 months, no restenosis, hematometra, or infection occurred, suggesting feasibility, though the small sample and short follow-up mean that safety and fertility benefits remain unproven.