Role of preoperative imaging in laparoscopic management of unicornuate uterus associated with a noncommunicating rudimentary horn: A report of three cases

Gonosuke Sonoda, Tetsuro Hatase, Hiroshi Terasaki, Sumire Mishima, Masanori Kawano
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2022 · vol. 38(2) , pp. 191–198 · doi:10.5180/jsgoe.38.2_191 · W4317923803
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

Laparoscopic resection of non-communicating rudimentary horns in unicornuate uteri can be successfully performed following preoperative imaging, such as MRA, to confirm uterine artery course.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This case report describes three women with a unicornuate uterus associated with a non-communicating rudimentary horn who underwent successful laparoscopic surgery to remove the rudimentary horn, the ipsilateral fallopian tube, and endometriotic ovarian cysts. The authors emphasize the role of preoperative imaging—specifically magnetic resonance angiography and computed tomography angiography—to accurately confirm the uterine artery’s course, which they state is essential for safe surgical management. A limitation is that the evidence is limited to a small number of cases without a comparative evaluation of imaging methods. Relevance to endometriosis: the paper explicitly notes a high incidence of endometriosis associated with this Müllerian anomaly and reports removal of endometriotic ovarian cysts in the described patients, though the main focus is preoperative imaging for laparoscopic management of a non-communicating rudimentary horn rather than endometriosis pathology itself.

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Abstract

Unicornuate uterus with a rudimentary horn represents a Müllerian duct anomaly. We describe three women aged 20, 18, and 23 years with a unicornuate uterus associated with a non-communicating rudimentary horn, who underwent successful laparoscopic surgery. Studies have reported a high incidence of endometriosis associated with this anomaly. Therefore, prevention of progressive endometriosis and rudimentary horn resection are recommended as treatment. We performed successful laparoscopic removal of a non-communicating rudimentary horn, ipsilateral fallopian tube, and endometriotic ovarian cyst in our patients who underwent uneventful laparoscopic surgeries, following preoperative imaging to accurately confirm the course of the uterine artery. We performed magnetic resonance angiography (MRA) and computed tomography angiography for preoperative evaluation. Preoperative confirmation of the course of the uterine artery is essential, and MRA is a particularly useful modality in such cases.
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症例報告 腹腔鏡下手術を施行した非交通性副角子宮の３症例〜術前画像検査の重要性〜 2022 年 38 巻 2 号 p. 191-198 詳細 抄録 Unicornuate uterus with a rudimentary horn represents a Müllerian duct anomaly. We describe three women aged 20, 18, and 23 years with a unicornuate uterus associated with a non-communicating rudimentary horn, who underwent successful laparoscopic surgery. Studies have reported a high incidence of endometriosis associated with this anomaly. Therefore, prevention of progressive endometriosis and rudimentary horn resection are recommended as treatment. We performed successful laparoscopic removal of a non-communicating rudimentary horn, ipsilateral fallopian tube, and endometriotic ovarian cyst in our patients who underwent uneventful laparoscopic surgeries, following preoperative imaging to accurately confirm the course of the uterine artery. We performed magnetic resonance angiography (MRA) and computed tomography angiography for preoperative evaluation. Preoperative confirmation of the course of the uterine artery is essential, and MRA is a particularly useful modality in such cases. © 2022 日本産科婦人科内視鏡学会

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endometriosis

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