Dysmenorrhea due to a rare müllerian anomaly

Abstract

Müllerian duct anomalies may produce reproductive failure like abortion and preterm birth, or obstetric problems like malpresentation, retained placenta, etc., or they may be asymptomatic. Unicornuate uterus with a noncommunicating functional rudimentary horn is a type of müllerian anomaly that results in obstruction to menstrual blood flow, leading to endometriosis and dysmenorrhea. Though the majority of cases of dysmenorrhea in adolescents are primary in nature and require only reassurance and symptomatic management, it is important to be aware of rare causes such as müllerian anomalies so that these cases can be properly managed. Hence, we present this case report, with interesting illustrations, so as to increase awareness regarding these anomalies.

Rapid Recurrence of Unilateral Endometrioma in a Teenager with a Noncommunicating Rudimentary Horn and Unicornuate Uterus

“…The unicornuate uterus with a rudimentary horn found in our patient results from a defective development and fusion of müllerian ducts [2]. As it is usually accompanied by ipsilateral renal agenesis or ipsilateral pelvic kidney [1], they had to be dismissed by MRI.…”

“…Both the anatomic distribution of endometriotic lesions, and the high prevalence of endometriosis among adolescent girls with congenital outflow obstruction, favours the retrograde menstruation theory [4]. In this sense, unicornuate uterus has been found in 1/1000 women [2] [5], which may have added a rudimentary horn with or without a functional cavity [1]. This müllerian malformation is associated with endometriosis in up to 40% of cases [2].…”

“…In this sense, unicornuate uterus has been found in 1/1000 women [2] [5], which may have added a rudimentary horn with or without a functional cavity [1]. This müllerian malformation is associated with endometriosis in up to 40% of cases [2]. Interestingly, the rudimentary horn is noncommunicating in 75% of cases [1] [5].…”

“…Müllerian malformations result from an interrupted development, incomplete fusion or resorption of müllerian ducts. These anomalies are often associated with primary amenorrhea, infertility, obstetric complications, and endometriosis [1] [2]. Approximately 20% of all müllerian duct anomalies are constituted by the unicornuate uterus.…”

Is Magnetic Resonance Imaging Sufficient to Diagnose Rudimentary Uterine Horn? A Case Report and Review of the Literature

“…Pelvic pain and dysmenorrhea manifest due to obstruction and/or endometriosis. Such patients may also seek evaluation due to infertility or a history of recurrent obstetrical complications (3,4). …”