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In female pediatric patients, AA can manifest as abnormal uterine bleeding (AUB), including heavy menstrual bleeding (HMB), along with suspected intrauterine infection, while comprehensive guidelines remain unavailable. This case describes successful bone marrow transplantation after treating AUB with hysteroscopic vaginoscopy combined with a mechanical hysteroscopic tissue removal system, supported by endometrium protection, hymen preservation, and hematologic safety.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/vaginoscopy-approach-with-mechanical-tissue-removal-system-for-aub-in-pediatric-aplastic-anemia-a-case-report/442426/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/vaginoscopy-approach-with-mechanical-tissue-removal-system-for-aub-in-pediatric-aplastic-anemia-a-case-report/442426.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What condition does the case focus on in pediatric patients?","Question",{"text":113,"@type":114},"The case focuses on aplastic anemia in a pediatric patient presenting with abnormal uterine bleeding (AUB), including heavy menstrual bleeding, and suspected intrauterine infection.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the abnormal uterine lesion managed?",{"text":118,"@type":114},"The lesion was removed using hysteroscopic vaginoscopy combined with a mechanical hysteroscopic tissue removal system (mHTRs).",{"name":120,"@type":111,"acceptedAnswer":121},"Why was multidisciplinary cooperation and transfusion strategy emphasized?",{"text":122,"@type":114},"The report highlights that multidisciplinary collaboration and precise transfusion management were used to achieve hematologic safety, protect the endometrium, preserve hymen integrity, and maintain hemodynamic safety before bone marrow transplantation.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},442426,1790741562,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","Ding et al. BMC Surgery (2026) 26:4 [https://doi.org/10.1186/s12893-025-03393-8](https://doi.org/10.1186/s12893-025-03393-8)  \nBMC Surgery  \nCASE REPORT Open Access  \nVaginoscopy approach with Mechanical Tissue Removal System for AUB inPediatric Aplastic Anemia: a case report  \nDong Ding 1, Shengpeng Zhang 1, Xiaoyu Shi 1, Xiaohui Hou 1, Xinxin Zou 1 and Limin Feng 1*  \nAbstract  \nBackground Aplastic anemia (AA) is a rare childhood blood disease characterized by anemia, infection, and a tendency for hemorrhage. AA may present as abnormal uterine bleeding (AUB) and intrauterine infection in female patients with menstrual cycles. The management of AA-associated AUB in pediatric patients remains a significant challenge due to the absence of established, comprehensive guidelines. We report a rare case of a patient who successfully underwent bone marrow transplantation (BMT) after treatment with vaginoscopy combined with a mechanical hysteroscopic tissue removal system (mHTRs) .  \nCase presentation A 10-year-old female patient, diagnosed with AA for four years, presented with heavy menstrual bleeding (HMB) and lower abdominal pain accompanied by fever for ten days. To ensure she could proceed with her scheduled BMT, she required management for AUB and suspected intrauterine infection. We removed the lesion via innovative vaginoscopy combined with mHTRs. Through multidisciplinary cooperation and a precise blood transfusion strategy, the procedure achieved the objects of endometrium protection, hymen preservation, and hematological safety.  \nConclusion For pediatric patients with AA-associated AUB, the combination of vaginoscopy and mHTRs represents a promising surgical alternative. Compared to traditional approaches, this technique allows minimally invasive lesion resection while preserving endometrium and hymen integrity, addressing the main concern for pediatric patients. Furthermore, integrating multidisciplinary expertise and precise transfusion management ensures the safety of surgery and hemodynamics. This approach provides a clinically feasible, patient-tailored solution for a complex population with limited treatment options.  \nKeywords Aplastic anemia, Abnormal uterine bleeding, Intrauterine infection, Vaginoscopy, Mechanical hysteroscopic tissue removal system  \n*Correspondence:  \nLimin Feng  \n[lucyfeng1966@163.com](lucyfeng1966@163.com)  \n1Department of Gynecology, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing, China  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creati](http://creati)[vecommons.org/l](vecommons.org/l)icenses/by-nc-nd/4.0/.  \nDing et al. BMC Surgery (2026) 26:4  \nBackground  \nAplastic anemia (AA) is a rare childhood blood disease characterized by persistent hypocellular bone marrow and pancytopenia without dysplasia or marrow fibrosis [1]. The typical clinical symptoms include anemia, infection, and a tendency towards hemorrhage. Female pediatric patients with AA may present with gynecological emergencies, such as intrauterine infection a","cbCaieHn6P8tvXdw","https://ap.wps.com/l/cbCaieHn6P8tvXdw","pdf",924234,"English","# Background\n# Case presentation\n## Patient history and presentation\n## Treatment approach\n# Conclusion","[{\"question\":\"What condition does the case focus on in pediatric patients?\",\"answer\":\"The case focuses on aplastic anemia in a pediatric patient presenting with abnormal uterine bleeding (AUB), including heavy menstrual bleeding, and suspected intrauterine infection.\"},{\"question\":\"How was the abnormal uterine lesion managed?\",\"answer\":\"The lesion was removed using hysteroscopic vaginoscopy combined with a mechanical hysteroscopic tissue removal system (mHTRs).\"},{\"question\":\"Why was multidisciplinary cooperation and transfusion strategy emphasized?\",\"answer\":\"The report highlights that multidisciplinary collaboration and precise transfusion management were used to achieve hematologic safety, protect the endometrium, preserve hymen integrity, and maintain hemodynamic safety before bone marrow transplantation.\"}]","Vaginoscopy approach with Mechanical Tissue Removal System for AUB in Pediatric Aplastic Anemia - a case report | PDF",1790700220,15]