A Bicornuate Uterus with a Unilateral Focal Adenomyosis: A Case Report

Adventa YI, Rachmawati A, Tjahyadi D, Ritonga MA
In: International Medical Case Reports Journal, Vol Volume 19, Iss Issue 1, Pp 1-7 (2026) · 2026 · W7125353752
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This case report describes a 43-year-old woman with a bicornuate uterus and unilateral focal adenomyosis who underwent hysterectomy for chronic pelvic pain and secondary infertility.

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This case report describes a 43-year-old woman with a bicornuate uterus who presented with chronic pelvic pain, severe dysmenorrhea, and secondary infertility. The patient had undergone two previous cesarean sections and curettage, procedures that may have contributed to the development of focal adenomyosis confined to the left hemiuterus. Following counseling on management options, she underwent a total abdominal hysterectomy via laparotomy, which resulted in the complete resolution of her pelvic symptoms without postoperative complications. This paper is centrally about adenomyosis — specifically unilateral focal adenomyosis occurring in the context of a congenital uterine anomaly.

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Abstract

Yohanes Iddo Adventa, Anita Rachmawati, Dian Tjahyadi, Mulyanusa Amarullah Ritonga Division of Fertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Bandung, IndonesiaCorrespondence: Yohanes Iddo Adventa, Division of Fertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Bandung, Indonesia, Tel +62 82297669494, Email [email protected]: The etiology of adenomyosis remains uncertain, and factors such as pregnancy, postpartum endometritis, cesarean delivery, uterine surgery, and uterine trauma are suspected to cause myometrial disruption that may trigger smooth muscle hyperplasia.Case: We present a case of a bicornuate uterus with focal adenomyosis confined to the left hemiuterus in a 43-year-old woman who experienced chronic pelvic pain, severe progressive dysmenorrhea, and secondary infertility for three years. She had previously been diagnosed with a bicornuate uterus during two cesarean sections and had a history of curettage, both of which may have contributed to the localized pathology. After thorough counseling regarding management options, a laparotomy total abdominal hysterectomy was performed primarily for pain relief. The postoperative course was uneventful, and the patient was discharged on the third day with complete resolution of pelvic pain, reporting a visual analogue score of 0/10 at follow-up.Discussion: Previous caesarean sections and curettage are possible in cases of a bicornuate uterus with adenomyosis pathology of hemiuterus. Pain caused by adenomyosis can be managed with laparotomy total abdominal hysterectomy as a gold standard management.Keywords: adenomyosis, bicornuate uterus, hemiuterine
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International Medical Case Reports Journal (Jan 2026) A Bicornuate Uterus with a Unilateral Focal Adenomyosis: A Case Report Abstract Yohanes Iddo Adventa, Anita Rachmawati, Dian Tjahyadi, Mulyanusa Amarullah Ritonga Division of Fertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Bandung, IndonesiaCorrespondence: Yohanes Iddo Adventa, Division of Fertility and Reproductive Endocrinology, Department of Obstetrics and Gynecology, Faculty of Medicine, Dr. Hasan Sadikin General Hospital, Padjadjaran University, Bandung, Indonesia, Tel +62 82297669494, Email [email protected]: The etiology of adenomyosis remains uncertain, and factors such as pregnancy, postpartum endometritis, cesarean delivery, uterine surgery, and uterine trauma are suspected to cause myometrial disruption that may trigger smooth muscle hyperplasia.Case: We present a case of a bicornuate uterus with focal adenomyosis confined to the left hemiuterus in a 43-year-old woman who experienced chronic pelvic pain, severe progressive dysmenorrhea, and secondary infertility for three years. She had previously been diagnosed with a bicornuate uterus during two cesarean sections and had a history of curettage, both of which may have contributed to the localized pathology. After thorough counseling regarding management options, a laparotomy total abdominal hysterectomy was performed primarily for pain relief. The postoperative course was uneventful, and the patient was discharged on the third day with complete resolution of pelvic pain, reporting a visual analogue score of 0/10 at follow-up.Discussion: Previous caesarean sections and curettage are possible in cases of a bicornuate uterus with adenomyosis pathology of hemiuterus. Pain caused by adenomyosis can be managed with laparotomy total abdominal hysterectomy as a gold standard management.Keywords: adenomyosis, bicornuate uterus, hemiuterine

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adenomyosischronic_pelvic_paindysmenorrheainfertility

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