Background: Unicornuate uteri occur in 1 in 5400; 74-90% are associated with a rudimentary horn. If the noncommunicating horn contains functional endometrium, it often requires surgical resection. There are fewer than 35 published cases describing laparoscopic resection of uterine horns. This series reviews the preoperative assessment, operative management, and postoperative imaging of the laparoscopic management of 5 functional noncommunicating uterine horns.
Cases: Our patients presented with pelvic pain, dysmenorrheal, and dyspareunia. All patients underwent preoperative imaging with ultrasound and MRI. The diagnosis in all cases was unicornuate uterus with functional, noncommunicating uterine horn.
Summary and conclusions: Mean age was 19.5 years. Preoperative assessment with MRI was found to be useful for surgical planning and anticipation of the amount of myometrial connection. Average operating time was 2:24. Mean length of stay was 0.8 nights. No procedures were converted to laparotomy and all patients recovered well. Postoperative MRIs indicate no myometrial abnormalities.