22 Views | Sep 15, 2021
Affliations: McMaster University
Mullerian anomalies resulting from improper fusion or development of the paramesonephric ducts account for symptoms of pelvic pain and fertility issues. In this video, we explore a case of a post-menarchal 14 year-old patient who presents with severe dysmenorrhea. Imaging findings were consistent with a functional non-communicating uterine horn. Despite medical suppression, the patient required surgery for intractable pain. Indications for surgical management and preoperative considerations are outlined. The necessary preoperative imaging helped to prepare for surgical excision of the non-communicating uterine horn. The ideal surgery includes 10 key surgical steps, including proper dissection of the retroperitoneum, use of blood-conserving strategies and delineation of the connecting band. Assessment for and treatment of any endometriosis can ensure optimal symptom management. By identifying these patients early with appropriate imaging and through meticulous surgical planning, laparoscopic treatment is both possible and restorative.