Progressive dysmenorrhoea due to a rare mullerian anomaly - A case report

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Ruma Sen Gupta, Shahana Shermin and Jesmin Jerin

Ibrahim Medical College & BIRDEM General Hospital, Bangladesh

: Androl Gynecol: Curr Res

Abstract

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Unicornuate uterus is rare (6.3%) and is usually associated with endometriosis and renal abnormalities. We present a case of a 22 years old, unmarried girl, with dysmenorrhoea since menarche which was progressively increasing for 1 year. Menstrual cycle was regular, flow average. Secondary sexual characteristics were normal. Abdomen was soft with no mass. USG showed normal size uterus and a right sided haemorrhagic cyst (?)/endometriotic cyst (3x4 cm). With the probable diagnosis of endometrioma, oral progesterone was given continuously for three months. Then she had regular menstrual cycle without dysmenorrhoea for 3 months and got married. Three months later she had severe unilateral dysmenorrhoea and dyspareunia. Abdomen was tense and tender. Uterus was normal size and a soft, severely tender ill defined mass felt through the right fornix. TVS revealed normal size uterus with a rudimentary horn on right side (?haemorrhagic cyst, 5x5 cm). MRI revealed unicornuate uterus with a rudimentary horn on right side with right sided hematosalpinx. There was no renal abnormality. By this time she became pregnant. Her pregnancy was in normal uterine cavity. At her 10 weeks of gestation she had incomplete abortion, and E&C was done. After three months on laparoscopy and hysteroscopy, uterus was found unicornuate with right sided non-communicating rudimentary horn with hematometra and hematosalpinx. Left fallopian tube and both ovaries were normal. Right sided salpingectomy with excision of the rudimentary horn was done. She had no complaints in subsequent follow up for 6 months and was advised to conceive.

Biography

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Ruma Sen Gupta has completed DGO and MCPS in Gynae and Obs in 2004 and FCPS in 2010. She is a life member of Obstetrics and gynaecological Society of Banladesh (OGSB) and Society of Laparoscopic Surgeons of Bangladesh (SLSB). She has a number of original papers published in national and international journals. Currently she is working as Registrar in Ibrahim Medical College & BIRDEM General Hospital, Dhaka, Bangladesh.

E-mail: ruma.sengupta.bd@gmail.com