Combined surgical access in patients with cyst of the canal of Nuck in combination with endometriosis of the round ligament of the uterus

R. Neftulaev, R. R. Neftulaev, M. E. Kotsepuga, M. Kotsepuga, L. Shcherbakova, L.S. Shcherbakova, S. Rodimov, А.Е. Бугеренко, A. Bugerenko
In: Vrach · 2026 · pp. 12 · doi:10.29296/25877305-2026-08-02 · W7212007788
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A literature review and clinical observations of 152 cases demonstrate that combined surgical access effectively treats cysts of the canal of Nuck with endometriosis without recurrence, while proposing endoscopic mesh hernioplasty for patients without inguinal hernia.

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Abstract

The cyst of the canal of Nuck is a cyst that grows along the course of the circular ligament of the uterus and develops from an anatomical defect that forms in the intrauterine period with insufficient obliteration of the processus vaginalis. It manifests itself in the form of a sac-like formation protruding towards the labia majora. Normally, the canal should be obliterated before the first year of life. Since the pathology is congenital and not widespread, many doctors may encounter difficulties in the process of diagnosis, mistakenly interpreting it as an inguinal hernia. Incorrect differential diagnosis in such cases can lead to unjustified emergency surgical interventions. A controversial issue in this area is the choice of the optimal method of surgical intervention for the treatment of this pathology, since today there is no specific standard treatment. Descriptions of various surgical approaches to the treatment of cyst of the canal of Nuck in combination with other pathologies of the inguinal region exist in the literature. A literature review was conducted, which included 13 papers on 152 cases of treatment of cyst of the canal of Nuck. The review was also complimented by our own clinical observations. In the first clinical case, a cyst of the canal of Nuck was accompanied by the formation of an inguinal hernia. Endometriosis of the canal of Nuck was observed in the second case. Surgical removal of the cyst was performed by combined surgical access. In all cases, the operations were performed effectively without clinical signs of recurrence. In addition to the choice of surgical access, the question of choosing a hernioplasty method after removal of the cyst of the canal of Nuck in patients without inguinal hernia remains unresolved. In this work, we propose to perform an endoscopic plastic surgery of the hernial gate using a mesh implant.

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