A case report of laparoscopic surgery for Mayer-Rokitansky-Küster-Hauser syndrome with preservation of functional primordial uterus

BMC Womens Health. 2023 Nov 27;23(1):634. doi: 10.1186/s12905-023-02741-1.

Abstract

Background: In the past, the primary treatment for MRKH syndrome (Mayer-Rokitansky-Küster-Hauser syndrome) with a functional primordial uterus was surgical removal of the functional primordial uterus. In rare instances, the endometrium of the functional primordial uterus is well developed, and surgical preservation of the functional primordial uterus provides the possibility of preserving reproductive function for these patients.

Case presentation: A 14-year-old female was diagnosed with type I MRKH syndrome with a functional primordial uterus through physical examination and imaging investigations. We freed the functional primordial uterus through laparoscopic surgery and excised a portion of the lower myometrium to create an outlet at a lower uterine segment, which we then intermittently anastomosed to the tip of the artificial vagina. The patient recovered well after the surgery, and a re-examination showed no significant abnormalities.

Conclusion: We were successful in preserving the functional primordial uterus using laparoscopic surgery in a patient with MRKH syndrome and connecting it to an artificial vagina through reconstructive surgery to ensure unobstructed menstrual drainage and preserve the reproductive potential of the patient.

Keywords: Laparoscopic surgery; MRKH syndrome; Preservation of functional primordial uterus; Reproductive potential.

Publication types

  • Case Reports

MeSH terms

  • 46, XX Disorders of Sex Development* / complications
  • 46, XX Disorders of Sex Development* / diagnosis
  • 46, XX Disorders of Sex Development* / surgery
  • Adolescent
  • Congenital Abnormalities* / surgery
  • Female
  • Humans
  • Laparoscopy* / methods
  • Mullerian Ducts / surgery
  • Uterus / surgery
  • Vagina / surgery

Supplementary concepts

  • Mullerian aplasia