Grechukhina Olga, English Diana P, Miller Devin, Ratner Elena
Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA.
Am J Case Rep. 2016 May 16;17:331-6. doi: 10.12659/ajcr.897080.
Müllerian duct anomalies represent a wide spectrum of congenital abnormalities ranging from simple uterine anomalies to more complex multisystem derangements. Complete duplication of uterus, cervix, and vagina may be associated with urologic and caudal gastrointestinal malformations.
We present a case report detailing the management of a morbidly obese patient with postmenopausal bleeding and thickened endometrial stripe who had a very rare condition of pelvic organ duplication, including 2 hemiuteri, 2 vaginas, 2 hemibladders, and 2 each of ovaries, fallopian tubes, kidneys, and ureters. Laparoscopic hysterectomy was complicated by difficulties understanding urinary system anatomy requiring intraoperative urology consultation and imaging.
Management of patients with urogenital duplication and abnormal uterine bleeding requires a thorough understanding of possible associated malformations. Thorough preoperative evaluation, careful surgical exploration, and multidisciplinary approach may be necessary to avoid urologic injury in such patients.
苗勒管异常代表了一系列广泛的先天性异常，从简单的子宫异常到更复杂的多系统紊乱。子宫、宫颈和阴道的完全重复可能与泌尿系统和尾部胃肠道畸形有关。
我们报告一例病例，详细介绍了一名病态肥胖的绝经后出血且子宫内膜增厚的患者的治疗情况，该患者患有非常罕见的盆腔器官重复情况，包括2个半子宫、2个阴道、2个半膀胱，以及卵巢、输卵管、肾脏和输尿管各2个。腹腔镜子宫切除术因难以理解泌尿系统解剖结构而变得复杂，术中需要泌尿外科会诊和影像学检查。
对于泌尿生殖系统重复且子宫出血异常的患者，治疗需要全面了解可能存在的相关畸形。可能需要进行全面的术前评估、仔细的手术探查以及多学科方法，以避免此类患者发生泌尿系统损伤。
