Hystero-Laparoscopic Communication of Right Non-Communicating Horn of Robert’s Uterus in a 16-Year-Old Girl with Severe Dysmenorrhea and Hematometra: A Case Report
Authors
- Polly Chatterjee Department of Gynaecology and Obstetrics, Senior Consultant, Eskag Sanjeevani Multispecialty Hospital Baghbazar, Kolkata, West Bengal, India
- Abhinibesh Chatterjee Department of Gynaecology and Obstetrics, Eskag Sanjeevani Multispecialty Hospital, Kolkata, India
- Avishek Bhadra Department of Gynaecology and Obstetrics, R.G. Kar Medical College and Hospital, Kolkata, India
- Rumela Biswas Department of Gynaecology and Obstetrics, Medical College and Hospital, Kolkata, India
Keywords:
- Adolescent gynaecology,
- Gynaecological surgery,
- Hysteroscopy,
- Laparoscopy,
- Diagnosis
Abstract
Introduction: Robert’s uterus, first described in 1970, is a rare variant of a complete, oblique septate uterus characterized by a non-communicating hemi-cavity and a contralateral unicornuate cavity. This anomaly can lead to obstructed menstrual flow, resulting in hematometra and associated complications such as hematosalpinx and endometriosis. We report a case of Robert’s uterus in a 16-year-old girl, highlighting the restoration of uterine anatomy.
Case Details: A 16-year-old girl presented with severe dysmenorrhea and prolonged menstrual flow since menarche. Previous MRI indicated a Mullerian duct anomaly with a non-communicating rudimentary horn. After initial management involving hystero-laparoscopy and drainage of hematometra, she experienced recurrent dysmenorrhea. A second hystero-laparoscopic procedure revealed adhesions, and the non-communicating horn was surgically communicated with the main cavity. The patient was discharged with oral contraceptives, and follow-up ultrasound showed a normal-sized uterus and regular, pain-free menstruation.
Discussion: Robert’s uterus arises from incomplete resorption of the uterine septum, leading to unique anatomical features and potential complications, including subfertility. Traditional management has included laparotomy; however, minimally invasive techniques like hysteroscopy and laparoscopy are now preferred due to reduced surgical trauma and better preservation of fertility.
Conclusion: Robert’s uterus is a rare anomaly that requires awareness among healthcare providers when evaluating young women with severe dysmenorrhea or suspected endometriosis. Timely diagnosis and appropriate management are essential to prevent severe complications and preserve future fertility, with hysteroscopic resection offering promising reproductive outcomes.
