Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen, 518020, Guangdong Province, China.
Shenzhen Key Laboratory on Technology for Early Diagnosis of Major Gynecologic Diseases, Shenzhen, ,518036, China.
J Ovarian Res. 2021 Nov 22;14(1):167. doi: 10.1186/s13048-021-00898-7.
Congenital anatomic abnormalities of fallopian tubes and ovaries are rarely reported. Herein, we describe four cases of undescended ovary during laparoscopic surgery with abnormal anatomy of fallopian tube, yet without abnormal uterine development and urinary system abnormalities, which are analyzed by their clinical features and effects on reproductive function.
For the patients with undescended ovary, the location of unilateral or bilateral upper poles of the ovaries were usually much higher than that of the bifurcation of the common iliac vessel, and the fallopian tubes at the same side opened in the para-colonic sulcus. Among these four patients, two patients had primary infertility, one patient had tubal pregnancy rupture and bleeding, and one patient had uterine leiomyoma. The development of uterus was normal in all cases, and there was no abnormal development of urinary system. During the infertility examination, the fact that fallopian tubes lifted up in hysterosalpingography (HSG) might be regarded as an indicator of possible undescended ovary. The pelvic ultrasonography examination was of limited use in diagnosing undescended ovary.
Laparoscopy is the gold standard for the diagnosis of undescended ovary. When there is periodic post-sacral spinal pain, MRI or HSG can be used for diagnosis of undescended ovary.
输卵管和卵巢先天性解剖异常很少见。在此,我们描述了 4 例腹腔镜手术中输卵管解剖异常伴未降卵巢的病例,这些病例均无子宫发育异常和泌尿系统异常,并根据其临床特征和对生殖功能的影响进行了分析。
对于未降卵巢的患者,单侧或双侧卵巢上极的位置通常比髂总血管分叉处高得多,同侧的输卵管开口于结肠旁沟。这 4 例患者中,2 例原发性不孕,1 例输卵管妊娠破裂出血,1 例子宫肌瘤。所有患者的子宫发育正常,泌尿系统无异常发育。在不孕检查中,子宫输卵管造影(HSG)中输卵管抬起的事实可能被视为可能存在未降卵巢的指标。盆腔超声检查在诊断未降卵巢方面作用有限。
腹腔镜检查是诊断未降卵巢的金标准。当存在周期性荐骨后脊柱疼痛时,可使用 MRI 或 HSG 进行未降卵巢的诊断。