Rare case of hematometra in rudimentary horn of unicornuate uterus after tubal ligation
Keywords:Hematometra, Non-communicating rudimentary horn, Tubal ligation, Unicornuate uterus
Congenital anomalies of the uterus and vagina are associated with a high incidence of infertility and multiple obstetric problems. Unicornuate uterus with rudimentary horn is a rare mullerian duct anomaly of female genital tract with incidence of 1/100000. It usually develops following insufficient development of mullerian ducts. These patients present with dysmenorrhea, dyspareunia, and chronic pelvic pain because of endometriosis and rarely with acute abdominal symptoms following distention and torsion of the non-communicating rudimentary horn. A case of a unicornuate uterus with non-communicating rudimentary horn with functional endometrium developing hematometra after tubal ligation is presented herein.
Syed I, Hussain HK, Weadock W, Ellis J. Uterus, Mullerian duct abnormalities. An Online Rev Art Emed Webs. 2002 Aug 13.
Adhesions A. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Mullerian anomalies and intrauterine adhesions. Fertil Steril. 1988;49(6):944.
Atmaca R, Germen AT, Burak F, Kafkasli A. Acute abdomen in a case with noncommunicating rudimentary horn and unicornuate uterus. JSLS: J Soc Laparoendoscop Surg. 2005 Apr;9(2):235.
Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Human Reprod Update. 2011 Jun 24;17(6):761-71.
Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Human Reprod Update. 2001 Mar 1;7(2):161-74.
Saravelos SH, Cocksedge KA, Li TC. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Human Reprod Update. 2008 Jun 6;14(5):415-29.
Grimbizis GF, Campo R. Congenital malformations of the female genital tract: the need for a new classification system. Fertil Steril. 2010;94(2):401-7.
Chang CY, Chang SY, Changchien CC, Lui CC, Huang HW. Hematometra of the rudimentary horn of a unicornuate uterus resulting from cesarean section. Am J Obstet Gynecol. 2001 Nov 1;185(5):1263-4.
Robischon K, Baram DA, Phipps WR. Presentation of a Müllerian anomaly with outflow obstruction after tubal ligation. Fertil Steril. 1996;65(4):866-8.
Buttram Jr VC, Gibbons WE. Müllerian anomalies: a proposed classification (an analysis of 144 cases). Fertil Steril. 1979 Jul 1;32(1):40-6.
Heinonen PK. Clinical implications of the unicornuate uterus with rudimentary horn. Int J Gynecol Obstet. 1983 Apr 1;21(2):145-50.
Lee CY, Cheng WC, Hwang JL. Delayed severe dysmenorrhea after tubal ligation in a patient with rudimentary horn: a case report. Taiwanese J Obstet Gynecol. 2005 Mar 1;44(1):87-90.