Primary cervico-uterine anastomosis in a patient with agenesis of the uterine isthmus: A case report and review

Arrested caudal extension of the fused Müllerian ducts, either complete or segmental, causes obstruction of the outflow tract. We describe a case of agenesis of the uterine isthmus and the procedure to establish the continuity of the outflow tract. A 15-year-old girl with cyclic pelvic pain and amenorrhea was found to have a 3-cm gap between the uterine body and the cervix. After cervico-uterine anastomosis via laparotomy she menstruated normally and was pain-free. Selected cases of arrested Müllerian duct extension can be corrected by primary anastomosis, which establishes anatomical continuity and restores menstruation and, possibly, future fertility.