DEAR EDITOR,

Pelvic pain is a common gynaecological problem. A non-communicating rudimentary horn with a functional endometrial cavity may cause retrograde expulsion of menstrual debris and lead to endometriosis and infertility. We report a case of a bicornuate uterus with both non-communicating uterine cavities and dysgenesis at isthmic level and associated endometriosis who reported to us for chronic pelvic pain and had to undergo surgical removal of the horn and subsequently hysterectomy for resolution of symptoms. A nulliparous thirty three year old female presented with chronic cyclical pelvic pain and a history of primary amenorrhoea and primary infertility. Pain was not alleviated by medical therapy and was interfering with her social life. Physical examination revealed an overweight woman (BMI- 28) with normal secondary sex characters. Per speculum examination revealed a normal looking cervix. Pelvic examination revealed anteverted, normal sized uterus. Investigations for amenorrhoea and infertility were done and reported normal. MRI showed uterus bicornis unicollis with hypoplastic right uterine horn and larger left endometrial cavity with well developed uterine musculature around it and apparently communicating with cervix. With a provisional diagnosis of a bicornis unicollis uterus with rudimentary horn, hysterolaparoscopy was decided. Hysteroscopy was tried but access to main uterine cavity could not be attained due