Chronic pelvic pain can result from noncommunicating uterine cavities in patients
with müllerian anomalies. Traditional management has been to resect the noncommunicating
uterine horn. Two cases are described. One had a unicornuate uterus with noncommunicating
left uterine horn (American Fertility Society [AFS] classification IIb) and the other
had a normal external uterine contour with noncommunicating left uterine cavity that
did not fit any category of the AFS classification of müllerian anomalies. Attempts
at connecting the noncommunicating cavities hysteroscopically failed in both cases.
Successful unification of the cavities was subsequently achieved in the first case
using the classic Strassman metroplasty with the assistance of the robot. The unification
of uterine cavities was achieved using a modified Strassman metroplasty in the second
patient, as there was no uterine horn for landmark. Robot assistance was utilized
in this case as well. Both patients are symptom free after surgery. We conclude that
laparoscopic Strassman metroplasty, with or without robot assistance, is a viable
alternative to resection of uterine horns in patients with hematometra, chronic pelvic
pain, and noncommunicating uterine cavities.
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References
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Article Info
Publication History
Published online: September 09, 2015
Footnotes
Dr Bhagavath is a paid consultant for Hologic.
Cite this article as: Bhagavath B, Behrman E, Salari BW, et al. Metroplasty to treat chronic pelvic pain resulting from outflow tract müllerian anomalies. Am J Obstet Gynecol 2015;213;871.e1-3.
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Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
