Obstructive Mullerian Anomalies and Modern Laparoscopic Management

Abstract 

Study Objective

Congenital uterine anomalies are common, although the majority are asymptomatic. When an obstructed system exists, women may present with abdominal pain, or dysmenorrhea. Removal of the obstructed horn may be required in the symptomatic patient. In the past, surgical treatment necessitated a laparotomy.

Design

After preoperative diagnosis and planning using magnetic resonance imaging, laparoscopic removal of the obstructed uterine horn and tube was performed. Morcellation of tissue was used to permit removal through a 15mm port.

Setting

A central London tertiary referral teaching hospital.

Participants

15 women aged between 13 and 41.

Interventions

Between 1999 and 2005, all women underwent laparoscopic removal of the obstructed uterine horn and tube.

Main Outcome Measures

Recovery, hospital stay, length of operation.

Results

All women recovered well, with an operation time of 80 to 300 minutes and an average hospital stay of 5 days.

Conclusions

A laparoscopic approach is a safe and appropriate technique for the removal of an obstructed uterine horn.

Key Words: Mullerian anomalies, Laparoscopy, Uterine horn, Obstruction