Unicornuate uterus with noncommunicating functional horn: diagnostic workup and laparoscopic horn amputation

Abstract

Objective: To describe the diagnosis and the management of hematometra in a patient with unicornuate uterus with noncommunicating functional horn (hemi uterus and rudimentary uterine hemicavity).

Design: Video case report.

Setting: Minimally invasive gynaecology unit.

Patient(s): Sixteen-year-old nulliparous woman admitted to the gynaecologic emergency department with pelvic pain during menses.

Intervention(s): Two-dimensional transvaginal ultrasound, magnetic resonance imaging, and laparoscopic rudimentary horn resection.

Main outcome measure(s): Description of a case of anomaly of the female reproductive tract treated by laparoscopy.

Result(s): After pain reduction and stabilization of clinical condition, ultrasound and magnetic resonance were performed, which detected a hemi uterus with a right rudimentary uterine hemicavity and a hematosalpinx. The removal of the right rudimentary uterine horn was successfully performed. The patient was in good health at the 3-month follow-up visit.

Conclusion(s): Laparoscopic amputation of a functional rudimentary horn is considered the basic and traditional surgical option for women with hemiuterus. A detailed diagnostic evaluation should be performed to avoid misdiagnoses of other anomalies with blind hemicavity, which may be treated by hysteroscopy. Laparoscopic surgery with minimally invasive approach could be an essential tool to treat these cases, achieving optimal results with low postsurgical pain and a short hospital stay.

Keywords: Laparoscopy; uterine anomalies; uterine horn.