Uterus didelphys associated with ovarian endometriosis in an infertile patient

Ivana Rudic-Biljic-Erski, Mladenko Vasiljević, S. Rakic, Olivera Dzatic-Smiljkovic, Sladjana Mihajlovic
In: Vojnosanitetski pregled · 2017 · vol. 76(7) , pp. 749–752 · doi:10.2298/vsp170113148r · W2764051907
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This case report details the laparoscopic treatment of an endometriotic ovarian cyst in a patient with nonobstructive uterus didelphys, a rare simultaneous occurrence.

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This paper reports a rare clinical case of a 29-year-old nulliparous infertile patient with nonobstructive uterus didelphys occurring simultaneously with an ovarian endometriotic cyst. The authors diagnosed right ovarian endometriosis and uterus didelphys using bimanual examination and 2D transvaginal ultrasound, with confirmation by laparoscopy and magnetic resonance imaging, then performed laparoscopic incision/drainage, biopsy, and coagulation of endometriotic lesions with histopathology confirming ovarian endometriosis. Postoperatively, the patient received a gonadotropin-releasing hormone analogue for 3 months; the paper states that 10 months after completion there was no disease recurrence. This paper is centrally about endometriosis — specifically an association between ovarian endometriosis and a congenital uterine anomaly (uterus didelphys) in an infertile patient.

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Abstract

Introduction. Uterus didelphys results when Mullerian duct fusion is completely arrested during development. We presented a rare case of nonobstructive uterus didelphys occurring simultaneously with an endometriotic cyst of the ovary. Case report. A twenty-nine-year-old, nulliparous patient was admitted to our Clinic for laparoscopic treatment of an endometriotic ovarian cyst. Diagnoses of right ovarian endometriotic cyst and nonobstructed uterus didelphys were established with bimanual pelvic exam and two-dimensional transvaginal ultrasound. Diagnoses were subsequently confirmed by laparoscopy and magnetic resonance imaging. Laparoscopic incision and drainage of the endometriotic cyst were performed, followed by biopsy and coagulation of endometriotic lesions. Histopathology confirmed ovarian endometriosis. Gonadotropinreleasing hormone analogue (GnRHa) was prescribed postoperatively, for a total of 3 months. Ten months after completion of treatment, the patients was without disease recurence. Conclusion. Nonobstructive uterus didelphys is rarely associated with ovarian endometriosis.
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Vojnosanitetski pregled 2019 Volume 76, Issue 7, Pages: 749-752 Uterus didelphys associated with ovarian endometriosis in an infertile patient Rudić-Biljić-Erski Ivana (Clinic of Gynecology and Obstetrics „Narodni Front“, Belgrade, Serbia) Introduction. Uterus didelphys results when Mullerian duct fusion is completely arrested during development. We presented a rare case of nonobstructive uterus didelphys occurring simultaneously with an endometriotic cyst of the ovary. Case report. A twenty-nine-year-old, nulliparous patient was admitted to our Clinic for laparoscopic treatment of an endometriotic ovarian cyst. Diagnoses of right ovarian endometriotic cyst and nonobstructed uterus didelphys were established with bimanual pelvic exam and two-dimensional transvaginal ultrasound. Diagnoses were subsequently confirmed by laparoscopy and magnetic resonance imaging. Laparoscopic incision and drainage of the endometriotic cyst were performed, followed by biopsy and coagulation of endometriotic lesions. Histopathology confirmed ovarian endometriosis. Gonadotropinreleasing hormone analogue (GnRHa) was prescribed postoperatively, for a total of 3 months. Ten months after completion of treatment, the patients was without disease recurence. Conclusion. Nonobstructive uterus didelphys is rarely associated with ovarian endometriosis. Keywords: uterus, congenital abnormalities, ovary, infertility, endometriosis, laparoscopy, treatment outcome https://doi.org/10.2298/VSP170113148R Full text ( 567 KB) Cited by Vasiljević Mladenko (Clinic of Gynecology and Obstetrics „Narodni Front“, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia) Rakić Snežana (Clinic of Gynecology and Obstetrics „Narodni Front“, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia) Džatić-Smiljković Olivera (Clinic of Gynecology and Obstetrics „Narodni Front“, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia) Mihajlović Slađana (Clinic of Gynecology and Obstetrics „Narodni Front“, Belgrade, Serbia)

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