Müllerian duct anomalies: successful endoscopic management of a hybrid bicornuate/septate variety

Abstract

Study objective: To highlight the coexistence of uterine septum in cases diagnosed as bicornuate uterus on basis of the external shape of uterine fundus.

Study design: Case report with description of the technique.

Setting: Women's Health Assiut University Hospital.

Participants: An adolescent female with progressive pains dating since menarche.

Interventions: Hysteroscopic resection under laparoscopic monitoring through an intact hymen.

Main outcome measure: Operative time, complications, postoperative abdominal pain, appearance of the uterine cavity

Results: A patient with a septate uterus with a fundal depression and hemiuterine obstruction underwent hysteroscopic resection under laparoscopic monitoring. Laparoscopy was beneficial in diagnosis and treatment of associated pathology and monitoring the hysteroscopic procedure. Hysteroscopic metroplasty was performed and resulted in unification of the lower two thirds of the uterus. Dysmenorrhea was dramatically improved after the procedure. Subsequent office hysteroscopy confirmed restoration of a unified lower uterine corpus anatomy mimic to the original bicornuate state.

Conclusions: External fundal depression which characterizes bicornuate uterus was associated with a septate uterus with hemi uterine obstruction. This report demonstrates the coexistence of the two anomalies. Endoscopic management of this patient was safe and successful.