10-steps laparoscopic excision for a rudimentary uterine horn

Abstract

Uterine malformations of the rudimentary horn type affect 2 to 4 % of women. Resulting from a defect in the fusion of Muller's ducts, they are responsible for dysmenorrhea and lead to ectopic pregnancies, as well as endometriosis. These implications mean that their removal is recommended in young patients with a potential desire for pregnancy. In addition, rudimentary uterine horns are associated with renal anomalies in 20–30 % of cases.

We managed three patients with different histories for rudimentary uterine horns. We described ten surgical steps to explore and manage these rudimentary horns: abdominal exploration, tubal blue test, coagulation, section of mesosalpinx, round ligament, broad ligament, uterine pedicle, section and excision of horn, cavitary blue test, hysterorrhaphy and ovariopexy. This last step is optional.

We created a video outlining the major steps involved in the removal of this rare malformation, which proves to be a simple surgery with triple benefits. Nevertheless, there is a lack of data to enable us to make recommendations regarding subsequent pregnancies (such as time to conception, route of delivery).