Laparoscopic Approach of a Unicornuate Uterus with Noncommunicating Rudimentary Horns

Abstract

Background. Müllerian duct malformations delineate a miscellaneous group of congenital anomalies that result from arrested development, abnormal formation, or incomplete fusion of the mesonephric ducts. Case. This paper describes the diagnosis and management of a noncommunicating rudimentary horn complicated by severe pelvic pain and associated endometriosis. Conclusion. This condition was diagnosed by laparoscopy and hysteroscopy examination. Operative videolaparoscopy proved to be a successful approach for the treatment of this congenital Müllerian anomaly.

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. Infertility and poor obstetric outcomes, such as intrauterine growth restriction, fetal anomalous presentation or preterm delivery, are associated with this müllerian malformation [6].…”

“…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].…”

“…Infertility and poor obstetric outcomes, such as intrauterine growth restriction, fetal anomalous presentation or preterm delivery, are associated with this müllerian malformation [6]. Obstetric complications in the rudimentary communicating horn, including ectopic pregnancy, miscarriage or uterine rupture, and drawbacks associated with a rudimentary noncommunicating horn with functional endometrium, such as endometriosis, are well known [1]- [3] [5] [6]. Thus, management involves removal of the rudimentary horn with a functional endometrial cavity [1] [6].…”

“…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.…”

Comprehensive approach to the diagnosis, surgical correction and rehabilitation of patients with uterovaginal anomalies in combination with endometriosis

“…Это го-ворит о необходимости удаления рудиментарного маточного рога не только при патологических изме-нениях в них (беременность, миома), но и при не-функционирующем роге, ввиду высокого риска воз-никновения в нем эндометриоза. Данная тактика согласуется с хирургической методикой L. Medeiros (2011), G. Pados (2014) [25,26].…”