Department of Center for Reproductive Medicine, Center for Prenatal Diagnosis, First Hospital, Jilin University, 71 Xinmin Street, Chaoyang District, Changchun, 130021, Jilin Province, China.
Arch Gynecol Obstet. 2022 Oct;306(4):1069-1075. doi: 10.1007/s00404-022-06574-5. Epub 2022 Apr 29.
To summarize the clinical characteristics and surgical option of Robert's uterus.
We reported a rare case of Robert's uterus with severe uterine adhesion with successive laparoscopic and hysteroscopic surgery. To our knowledge, such a case has not been reported previously. We also performed a systematic literature review from the PubMed, Embase, and Cochrane databases.
Our patient with Robert's uterus with severe uterine adhesions was successfully treated with hysteroscopic septal resection and hysteroscopic adhesiolysis, and the intractable dysmenorrhea disappeared after the hysteroscopic septal resection. In our study, we analyzed the selected 22 reported cases, 10/22 cases (45.5%) were diagnosed before age 20; 20/22 cases (90.91%) experienced dysmenorrhea, 19/22 cases (86.36%) were with hematometra. 5/22 cases (22.73%) underwent re-operation or a third surgery before diagnosis and management.
Robert's uterus, a rare congenital abnormality of Mullerian duct development, consists of an oblique septum and non-communicating asymmetrical uterine hemi-cavity. The main symptoms are the presence of hematometra and severe dysmenorrhea. Septal resection is the main surgical procedure; however, the rarity and difficulty obtaining a pre-operative diagnosis lead to a high rate of misdiagnosis and second surgery.
总结罗伯特氏子宫的临床特征和手术选择。
我们报告了一例罕见的伴有严重子宫粘连的罗伯特氏子宫，采用连续腹腔镜和宫腔镜手术进行治疗。据我们所知，此前尚未有报道过此类病例。我们还对 PubMed、Embase 和 Cochrane 数据库进行了系统文献回顾。
我们的一例伴有严重子宫粘连的罗伯特氏子宫患者成功接受了宫腔镜隔切除术和宫腔镜粘连松解术治疗，宫腔镜隔切除术治疗后难治性痛经消失。在我们的研究中，我们分析了 22 例已报道的病例，10/22 例（45.5%）在 20 岁之前被诊断；20/22 例（90.91%）经历痛经，19/22 例（86.36%）有宫腔积血。5/22 例（22.73%）在诊断和治疗前接受了再次手术或第三次手术。
罗伯特氏子宫是一种罕见的苗勒管发育异常，由斜隔和非交通性不对称子宫半腔组成。主要症状为宫腔积血和严重痛经。隔切除术是主要的手术程序；然而，由于术前诊断困难且罕见，导致误诊率和二次手术率较高。
