A Stepwise Approach to Laparoscopic Excision of a Noncommunicating Rudimentary Horn

Jan, Haider; Katesmark, Michael; Ghai, Vishalli

doi:10.1016/j.jmig.2018.07.009

Cited by 6 publications

(5 citation statements)

References 2 publications

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“…To minimize the risk of penetration into the cavity of the hemiuterus while laparoscopic dissection, a hysteroscopic transillumination technique was performed in three cases by Nezhat et al ( 8 ) . In a recent study by Jan et al ( 9 ) , this technique was detailed in a technical video demonstrating the hysteroscopic transillumination of the plane of the dissection between the rudimentary horn and the uterus. At the beginning of the operation, we first performed a hysteroscopic evaluation of the uterine cavity to visualize the relation.…”

Section: Discussionmentioning

confidence: 99%

“…A monopolar hook may not be sufficient while resecting the rudimentary horn; thus, advanced bipolar energy devices are needed to control the bleeding as the rudimentary horn may receive blood from the myometrial arcuate arteries of the contralateral uterine artery ( 2 ) . In cases where a firmly attached horn is present, the laparoscopic surgeon should handle large myometrial defect with sutures for reconstruction after removal of the horn ( 9 ) . Moreover, if the patient has a desire for a future pregnancy, the myometrial defect should also be sutured to avoid probable uterine rupture.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic hemi-hysterectomy in a noncommunicating uterine horn: The critical steps to be considered

Altınbaş¹,

Tapisiz²,

Ünsal³

et al. 2020

tjod

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Various congenital anomalies of the female tract such as agenesis, vertical or lateral fusion failure, and canalization failure occur when the normal development of the Müllerian duct disrupts in any stage of developmental milestones. A cavitated non-communicating rudimentary horn is reported in about 20%-25% of women with unicornuate uterus. A 36-year-old patient, gravida 2 para 2, was admitted to the hospital with a complaint of worsening lower abdominal pain occurring on each menses for 8 months. A 6-cm accessory cavitated left uterine mass suggestive of hematometra was shown on ultrasound examination. It was decided to perform hemi-hysterectomy to remove the left uterine horn by the laparoscopic route. Here we aimed to demonstrate the laparoscopic management of a rudimentary horn case and emphasize the crucial steps that surgeons should safely perform during the operation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic hemi-hysterectomy in a noncommunicating uterine horn: The critical steps to be considered

Altınbaş¹,

Tapisiz²,

Ünsal³

et al. 2020

tjod

View full text Add to dashboard Cite

show abstract

“…3) Few studies described transillumination while performing hysteroscopy in these cases also helped in finding out correct plane of dissection [12]. However, Figure 2.…”

Section: Methodsmentioning

confidence: 99%

“…This alleviated damage to the hymen in unmarried girls. This helps in diagnosing presence of oblique vaginal septum, whether opening was present in the septum and correctly identifying communicating functional horn in case of didelphis uterus [11] [12].…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic Hemi-Hysterectomy-Retrospective Study of Case Series of over 9 Years

Shukla¹,

Shukla²,

Shah³

2019

OJOG

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Background: Word hemi-hysterectomy and removal of rudimentary functional horn may be used interchangeably in published data. The same term may be used when a non-obstructive hemi-uterus is removed when there is an associated pathology. The article tries to standardise classification of Mullerian dysgenesis where this procedure is required according to ESHRE ESGE classification, preoperative diagnosis and discuss the operative details. Objective: The objective was to study the demographic profile, symptoms, association of endometriosis, variation in the anatomy, accuracy of preoperative diagnosis, to classify according to ESHRE ESGE classification and to standardize the laparoscopic surgical steps of hemi-hysterectomy. Study Design: This is a retrospective case series of cases of Mullerian dysgenesis with obstructive hemi-uterus or non-obstructive hemi-uterus with pathology treated by laparoscopic hemi-hysterectomy. (Canadian task force classification III). Methods: Data from hospital electronic records of all cases tagged with word laparoscopic hemi-hysterectomy were collected for 9 years from Jan 2009 to Dec 2018. Results: Total 19 patients of hemi-hysterectomy were analysed. Pre-operative diagnosis was made in 100% of patients. 100% patients with obstructive horn had dysmenorrhoea. ESHRE ESGE class U4aC3V0 was more frequently seen followed by U5aC4V4 and U3bC3V2 as obstructive and U4bC3V0, as non-obstructive. Associated endometriosis along with other pathology was seen in 74% of the patients. 3 patients with HWWS had ipsilateral renal agenesis. Laparoscopic hemi-hysterectomy was offered to all such patients. The operative steps & variants were studied. Post-operative outcome was uneventful in all. Conclusion: An experienced surgeon should deal with these problems of Mullerian dysgenesis discussed in this study. The other variants diagnosed also must be treated by an experienced surgeon only. Laparoscopic hemi-hysterectomy is almost the most standard surgical method to How to cite this paper:

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“…However, if one side of the Müllerian duct develops normally and the opposite side is defective, a unicornuate uterus is formed. According to the classification system of the American Society of Reproductive Medicine (ASRM) in 1988, this case is a type IIb uterine malformation, a unicornuate uterus with a non-communicating rudimentary horn ( 1 , 4 ).…”

Section: Related Literature Learningmentioning

confidence: 99%

Case report: Rudimentary uterine horn with ovarian endometriosis manifested as pelvic ectopic kidney

et al. 2023

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BackgroundUnicornuate uterus is a congenital uterine malformation. Unicornuate uterus with rudimentary horn, ovarian endometriosis, and congenital renal agenesis are rare combinations that can be easily misdiagnosed due to the lack of typical clinical manifestations.Case summaryA 19-year-old woman with pelvic pain was admitted to the hospital after a month. Physical examination was unremarkable. B-ultrasound and CT scan both indicated pelvic ectopic kidney. In addition, renal scintigraphy revealed normal perfusion and function of the right kidney, but the perfusion and function of the left kidney were not visible. A left pelvic ectopic kidney was diagnosed by preoperative images. A laparoscopic left pelvic ectopic nephrectomy was performed after adequate surgical preparation. However, the postoperative pathological diagnosis revealed a rudimentary uterine horn with ovarian endometriosis and congenital renal agenesis. Fortunately, she got recovered and was discharged from the hospital after 5 days following the operation. Moreover, she received regular follow-ups at the gynecology clinic. To date, no right adnexal or uterine abnormalities have been detected on ultrasound during the follow-up visits.ConclusionRudimentary uterine horn with ovarian endometriosis and congenital renal agenesis are rare and are easily Misdiagnosed due to the lack of typical clinical manifestations. A gynecological examination is recommended for patients who may have this disease.

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A Stepwise Approach to Laparoscopic Excision of a Noncommunicating Rudimentary Horn

Cited by 6 publications

References 2 publications

Laparoscopic hemi-hysterectomy in a noncommunicating uterine horn: The critical steps to be considered

Laparoscopic hemi-hysterectomy in a noncommunicating uterine horn: The critical steps to be considered

Laparoscopic Hemi-Hysterectomy-Retrospective Study of Case Series of over 9 Years

Case report: Rudimentary uterine horn with ovarian endometriosis manifested as pelvic ectopic kidney

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