Laparoscopic resection of the rudimentary horn of a unicornuate uterus diagnosed by three-dimensional computed tomography

Abstract

A 16-year-old woman was admitted to the emergency room due to severe lower abdominal pain. She had no surgical or obstetric history. Menarche had occurred 2 years ago. She suffered from dysmenorrhea and pelvic cyclic pain during menstruation. The three-dimensional computed tomography combined with ultrasonography revealed a rudimentary horn of unicornuate uterus. We performed a laparoscopic removal of this uterine anomaly without any complication in the postoperative period. Laparoscopy resulted in anatomical and reproductive outcome equivalent to those offered by a laparotomic approach, and minimally invasive surgery had additional advantages such as, better cosmetic results and postoperative period, which are important for very young patients.

Coring‐type laparoscopic resection of a cavitated non‐communicating rudimentary horn under hysteroscopic assistance

“…In the adolescent population, virginity should not be a contraindication for the use of hysteroscopy as reported by Kim et al . Vaginoscopic hysteroscopy, without the use of a vaginal valve and tenaculum, can be performed in these cases as with our patient.…”

“…Kim et al . reported the advantage of 3‐D computed tomography over MRI in the case of a patient with a rudimentary horn of a unicornuate uterus . Similarly, our patient was evaluated by using TVS, IVP, and MRI for existing urogenital abnormalities.…”

“…Recently, 3‐D sonography has been suggested as a useful and cost‐effective tool when compared to MRI. Where operators are experienced, a sensitivity of 93% and a specificity of 100% have been reported when used in the assessment of Müllerian anomalies . Kim et al .…”

Uterine Adenomyosis Which Developed from Hypoplastic Uterus in Postmenopausal Woman with Mayer-Rokitansky-Kuster-Hauser Syndrome: A Case Report

“…They exhibit normal, symmetrical breast and pubic hair development, no visible vagina, and have no symptoms or signs of crytomenorrhea because the rudimentary uteri contain no functional endometrium, but, in approximately 10%, functional islands of endometrium may result in a hematometra and symptoms of cyclic pain 1,3. Magnetic resonance imaging (MRI) is still the most standardized tool for diagnosis, but three-dimensional computed tomography and a laparoscopic approach may be a feasible choice of diagnosis 4. Traditional operative treatment of women with Müllerian agenesis is McIndoe procedure, which is surgical creation of a neovagina involves dissection of the rectovaginal space and placement of a skin graft, held in place with a soft mold until the graft becomes established 5…”

“…1 , 3 Magnetic resonance imaging (MRI) is still the most standardized tool for diagnosis, but three-dimensional computed tomography and a laparoscopic approach may be a feasible choice of diagnosis. 4 Traditional operative treatment of women with Müllerian agenesis is McIndoe procedure, which is surgical creation of a neovagina involves dissection of the rectovaginal space and placement of a skin graft, held in place with a soft mold until the graft becomes established. 5 …”