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超声联合宫腔镜治疗罗伯逊氏子宫:病例报告及文献复习。

Ultrasound combined with hysteroscopy for optimum treatment of Robert's uterus: a case report and a review.

机构信息

Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, 215 Heping West Road, Shijiazhuang, 050000, Hebei, China.

出版信息

BMC Womens Health. 2022 Aug 7;22(1):334. doi: 10.1186/s12905-022-01903-x.

DOI:10.1186/s12905-022-01903-x
PMID:35934693
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9358804/
Abstract

BACKGROUND

Rbert's uterus, also known as asymmetric septate uterus, is a rare genital malformation first reported by Dr. Robert in 1970. Robert's uterus is characterized by a septate uterus with a blind hemicavity and an intact external fundus. According to some reports, Robert's uterus was typically managed by laparoscopic uterine resection of a hemicavity, laparoscopic endometrectomy, and even hysterectomy. Considering that fertility preservation is important in young patients, we recommend ultrasound-guided hysteroscopic septum resection as an optimum treatment for Robert's uterus.

CASE PRESENTATION

Herein is described a clinical case of Robert's uterus in a 15-year-old girl who was misdiagnosed for primary dysmenorrhea in the beginning. Magnetic resonance imaging (MRI) and 3-dimensional (3D) ultrasound identified an asymmetrical uterine septum. The patient was treated using ultrasound-guided hysteroscopic treatment without laparoscopy. The surgical procedure lasted less than an hour, and the symptoms of dysmenorrhea were relieved during a six months follow-up.

CONCLUSIONS

Ultrasound-guided hysteroscopic septum resection is the preferred treatment for Robert's uterus.

摘要

背景

罗伯特氏子宫,又称不对称分隔子宫,是一种罕见的生殖器畸形,由罗伯特医生于 1970 年首次报道。罗伯特氏子宫的特征是隔子宫伴有盲腔和完整的外部子宫底。根据一些报道,通常采用腹腔镜子宫半腔切除术、腹腔镜子宫内膜切除术,甚至子宫切除术来治疗罗伯特氏子宫。考虑到年轻患者的生育保存很重要,我们建议采用超声引导的宫腔镜子宫纵隔切除术作为罗伯特氏子宫的最佳治疗方法。

病例介绍

本文描述了一例 15 岁女孩的罗伯特氏子宫临床病例,该患者最初被误诊为原发性痛经。磁共振成像(MRI)和三维(3D)超声检查发现了不对称的子宫纵隔。该患者采用超声引导宫腔镜治疗,无需腹腔镜。手术过程不到一个小时,痛经症状在六个月的随访中得到缓解。

结论

超声引导宫腔镜子宫纵隔切除术是治疗罗伯特氏子宫的首选方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/1ec2895ad7f7/12905_2022_1903_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/cb52fb4c4fad/12905_2022_1903_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/9bf0bf4a6456/12905_2022_1903_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/9172da725b88/12905_2022_1903_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/1ec2895ad7f7/12905_2022_1903_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/cb52fb4c4fad/12905_2022_1903_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/9bf0bf4a6456/12905_2022_1903_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/9172da725b88/12905_2022_1903_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5267/9358804/1ec2895ad7f7/12905_2022_1903_Fig4_HTML.jpg

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Hysteroscopic Management of Robert's Uterus.罗伯特子宫的宫腔镜治疗
J Obstet Gynaecol India. 2020 Feb;70(1):86-88. doi: 10.1007/s13224-019-01208-4. Epub 2019 Mar 8.
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Assessment of Abdominal Ultrasound Guidance in Hysteroscopic Metroplasty.宫腔镜子宫肌层切开术中腹部超声引导的评估
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The comprehensiveness of the ESHRE/ESGE classification of female genital tract congenital anomalies: a systematic review of cases not classified by the AFS system.欧洲人类生殖与胚胎学会/欧洲妇科内镜学会女性生殖道先天性异常分类的全面性:对未按美国生育学会系统分类的病例的系统评价
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