Robot-Assisted Laparoscopic Hemihysterectomy for a Rare Genitourinary Malformation with Associated Duplication of the Inferior Vena Cava – A Case Report

摘要

Complex non-communicating Müllerian/Wolffian malformations are rare and a strict classification from an embryological point of view is sometimes difficult [1] [2]. For unknown reasons laterally distributed malformations are more often right-sided [14]. Diagnosis is often delayed due to the rarity of the condition but symptoms typically include increasingly severe dysmenorrhoea. A thorough preoperative investigation is mandatory to rule out other anomalies and to plan a correct surgical approach. Typically, the didelphic uterus is associated with an obstructed hemivagina and almost invariably an ipsilateral renal agenesis [9] [14]. These patients can be successfully treated by resection of the vaginal septum [7] [9]. Alternatively, a unicornuate uterus with a rudimentary horn, which covers a wide range of anatomic variability, requires a hemihysterectomy and sometimes an adnexectomy [8] [9]. These patients are reported to have ipsilateral renal agenesis in 38% of cases [9].