Management of mullerian development anomalies: 9 years' experience of a tertiary care center

Abstract

Objectives: This study aimed to analyze the clinical and imaging findings as well as the outcomes of patients with Mullerian duct anomalies. Materials and Methods: A retrospective analysis of 41 patients with Mullerian development anomalies treated in a tertiary care center in the past 9 years was done. The presenting symptoms, radiological findings, management, and the outcomes were evaluated. Results: According to the American Fertility Society's classification, 11 patients presented in Class I, 6 in Class II, and 24 in Class III of the classification. It was found that some of the defects such as the unicornuate uterus, a unicornuate uterus with noncommunicating rudimentary horn, and longitudinal vaginal septum were usually asymptomatic whereas disorders such as Mayer-Rokitansky-Küster-Hauser (MRKH), cervicovaginal atresia, and transverse vaginal septum presented with the absence of menarche, cyclical abdominal pain, and abdominal mass, respectively. Defects such as the bicornuate uterus, didelphys uterus, and septate uterus present with poor reproductive performance. Unicornuate uterus with communicating horn presented with rupture of the horn in the antenatal period, which was managed vigorously. Vaginoplasty with a skin graft and amnion graft had excellent results in MRKH syndrome. Patients with cervicovaginal atresia had a poor prognosis and ultimately required a hysterectomy. Hysteroscopic septal resection improved the reproductive performance in the patients with septate uterus. Conclusion: This study concluded that the management of uterine malformations is individualized depending on the symptoms and fertility concerns. Cervicovaginal atresia was associated with restenosis after surgery ultimately required a hysterectomy. MRKH had excellent results with McIndoe vaginoplasty. Optimal and timely management may lead to better outcomes.

Three-dimensional Laparoscopic Hemihysterectomy in a Case of Herlyn–Werner–Wunderlich Syndrome

“…Mullerian developmental anomalies arise from dysregulation or interruption in the processes of differentiation, migration, fusion, or canalization of Mullerian ducts and urogenital sinus. [ 1 ] With the improvement in minimally invasive surgery, laparoscopy and hysterectomy have replaced the conventional surgical method. [ 2 3 4 6 ]…”

Preparation of human amniotic membrane for transplantation in different application areas

“…The successful application of hAM in this field was already described in 1979 ( 184 ). Since then, various other groups have used this material with good clinical outcome ( 185 – 192 ). As both fresh and chemically processed and sterilized freeze-dried hAM were used, it can be assumed that the results are again based on the matrix effect of the membrane.…”

Laparoscopic Sigmoid Vaginoplasty for the Treatment of Mayer–Rokitansky–Kuster–Hauser Syndrome in a Single Center: 20 years’ Experience

“…However, each of these techniques has its limitations, such as stenosis, insufficient length, insufficient lubrication, risk of bladder injury, and high cost. Sigmoid vagina replacement can well imitate the normal vaginal structure in terms of morphology and function and is a relatively common operation at present [5]. In addition, laparoscopic surgery has the advantage of minimal trauma, quick recovery, minor post-operative pain, and an abdominal incision.…”