Consultant Minimally Invasive Gynaecologist, Endometriosis Centre, Apollo Health City, Hyderabad, India.
Consultant Minimally Invasive Gynaecologist, Endometriosis Centre, Apollo Health City, Hyderabad, India.
Fertil Steril. 2022 Oct;118(4):808-809. doi: 10.1016/j.fertnstert.2022.06.027. Epub 2022 Aug 8.
To present a case of didelphys uterus with severe pelvic pain and primary infertility with focal adenomyosis of outer myometrium (FOAM) of the left hemiuterus and tips and tricks for hemihysterectomy as a fertility preserving surgery.
Descriptive step-by-step video demonstration of a case of didelphys uterus with adenomyosis of the hemiuterus. Local institutional review board approval for publication was obtained.
Endometriosis Centre, Apollo Hospitals, Hyderabad, India.
PATIENT(S): Women with uterus didelphys with FOAM of the left hemiuterus with severe pelvic pain and infertility.
INTERVENTION(S): A 30-year-old woman presented with chronic pelvic pain and severe progressive dysmenorrhea with primary infertility for 3 years. She was diagnosed with uterus didelphys and longitudinal vaginal septum 3 years back and underwent hysteroscopy for septal resection and diagnostic laparoscopy for pain in an outside setting; however, no laparoscopic intervention was performed. The patient was diagnosed with FOAM of the left hemiuterus involving 75% of the hemiuterus. After detailed discussion and counseling regarding different options, laparoscopic hemihysterectomy was performed as pelvic pain relief was a major expected outcome along with fertility preservation.
MAIN OUTCOME MEASURE(S): Pain relief with improved quality of life and fertility preservation.
RESULT(S): The postoperative period was uneventful. The patient was discharged on the second postoperative day with no complaints. Her chronic pelvic pain and dysmenorrhea resolved. She was not prescribed any medication after the surgery. During the routine follow-up, she had a regular menstrual cycle with a visual analogue score of 0/10.
CONCLUSION(S): The safe removal of a hemiuterus in case of a didelphys uterus with pathology of hemiuterus through a minimally invasive technique is possible, which cures the pain caused by adenomyosis and enables quick recovery while preserving future fertility.
介绍一例因严重盆腔痛和原发性不孕而就诊的双子宫病例，该患者左半子宫的外肌层（FOAM）有局灶性子宫腺肌病，且半子宫的尖端有技巧和窍门，可进行半子宫切除术作为保留生育力的手术。
对一例双子宫伴腺肌病的病例进行描述性的分步视频演示。获得了当地机构审查委员会的出版批准。
印度海得拉巴 Apollo 医院子宫内膜异位症中心。
左半子宫有 FOAM 的双子宫患者，伴有严重盆腔痛和不孕。
一位 30 岁的女性因慢性盆腔痛和严重进行性痛经伴原发性不孕 3 年来就诊。她 3 年前被诊断为双子宫和纵隔阴道，在外院行宫腔镜下纵隔切除术和诊断性腹腔镜检查以缓解疼痛，但未行腹腔镜干预。患者被诊断为左半子宫的 FOAM，累及半子宫的 75%。在详细讨论和咨询了不同的选择后，由于缓解盆腔疼痛是主要预期结果，同时还能保留生育能力，因此进行了腹腔镜半子宫切除术。
疼痛缓解，生活质量提高，生育力保留。
术后恢复顺利。患者术后第 2 天无不适出院。她的慢性盆腔痛和痛经得到缓解。手术后没有给她开任何药物。在常规随访中，她的月经周期正常，视觉模拟评分（VAS）为 0/10。
通过微创技术安全切除有子宫腺肌病的双子宫的半子宫是可行的，这可以治愈由腺肌病引起的疼痛，使患者快速康复，同时保留未来的生育能力。
