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Article Abstract

Objective: To report three cases of Robert's uterus and to describe the types, diagnostic methods, and management options for this rare Mullerian anomaly.

Methods: Three adolescent girls presented with progressive severe dysmenorrhea since menarche. Two girls had undergone inappropriate surgeries due to misdiagnosis in past which did not relieve their symptoms. MRI reported as juvenile cystic adenomyoma (JCA) in one girl and Robert's uterus in other two girls.

Results: All three patients underwent surgical intervention. The first patient underwent laparoscopic blind horn resection and residual myometrial closure. The decision was taken in view of severe symptoms, school dropout, large adenomyotic lesion, and previous one appendicectomy following misdiagnosis, and patient was not willing for any conservative management. The other two patients underwent transabdominal ultrasonography-guided hysteroscopic resection of septum and hematometra drainage. All the patients had relieved from dysmenorrhea and are asymptomatic.

Conclusion: All girls presenting with progressive dysmenorrhea should be evaluated for Mullerian anomalies including the rare ones like Robert's uterus. USG-guided hysteroscopic septal resection may be considered for all cases of Robert's uterus for immediate symptom relief and better future reproductive outcomes. Further long-term follow-up of these patients undergoing conservative surgeries is warranted.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085458PMC
http://dx.doi.org/10.1007/s13224-024-02074-5DOI Listing

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Objective: To report three cases of Robert's uterus and to describe the types, diagnostic methods, and management options for this rare Mullerian anomaly.

Methods: Three adolescent girls presented with progressive severe dysmenorrhea since menarche. Two girls had undergone inappropriate surgeries due to misdiagnosis in past which did not relieve their symptoms.

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We report the case of a woman in her early 30 s who was diagnosed with Robert's uterus. She had been experiencing progressive dysmenorrhea for a decade and sought treatment for infertility at our hospital. Preoperative ultrasound imaging resulted in a misdiagnosis of a complete uterine septum with an accompanying ovarian cyst.

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Two patients of early adolescence age presented with medically resistant primary dysmenorrhoea. Imaging (MRI scan) confirmed an asymmetric uterine septum with a unilaterally obstructed horn with haematometra. Laparotomy and Tompkins metroplasty was performed to unify the uterine cavity in each case, a technique not used for this condition before.

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Article Synopsis
  • Gynaecologists should recognize rare conditions like Robert's uterus, as they may require surgical intervention for proper treatment.
  • A 41-year-old mother with Robert's uterus experienced a unique late onset of symptoms, previously undergoing treatment for a related ectopic pregnancy before successfully receiving laparoscopic and hysteroscopic treatment.
  • Combining laparoscopy and hysteroscopy is an effective, minimally invasive surgical approach that offers superior recovery compared to traditional open surgery for managing obstructive Mullerian anomalies.
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