In a groundbreaking medical case, doctors announced on Thursday that they had successfully treated an exceptionally rare case of half uterus, known as left unicornuate uterus, with adenomyosis in a non-communicating rudimentary horn, which is a first-ever occurrence in India.
Unicornuate uterus is a congenital condition characterized by having only half a uterus. 1
Adenomyosis occurs when the tissue that normally lines the uterus, i.e., endometrial tissue, grows into the muscular wall of the uterus. The replaced tissue continues to act normally, like thickening, breaking down, and bleeding during each menstrual cycle. It can result in an enlarged uterus and painful, heavy periods. 2
According to a statement from C.K. Birla Hospital in Gurugram, the patient, a 27-year-old woman, sought medical assistance in February due to pelvic pressure, persistent pain on the right side of her lower abdomen and pelvis, and infertility issues.
Initially, clinical examinations revealed a large, firm lump on the right side of her lower abdomen, which was suspected to be a fibroid. But detailed diagnostic hysteroscopy (a procedure used to examine the inside of the womb) and robotic myomectomy (removal of uterine fibroids) revealed a left unicornuate uterus with adenomyosis in the non-communicating right horn, attached to a large fibroid-like mass.
The doctors explained, addressing the complex anomaly, that it required precise dissection and extraction while ensuring the preservation of surrounding structures such as the intestines and urinary bladder.
Director of Obstetrics and Gynecology, Dr. Aruna Kalra, highlighted the uniqueness of the case, citing the rarity of a functioning non-communicating rudimentary horn combined with adenomyosis. The successful treatment involved a complete robotic-assisted excision of the entire horn, resulting in notable improvement in the patient's condition.
The final histopathology confirmed adenomyosis in the rudimentary horn, which is contributing valuable insights to the limited cases reported worldwide. Dr. Kalra emphasized that such cases can present various clinical manifestations, ranging from mild pain to complications like pelvic pain, endometriosis, or obstetrical issues.
The woman was hospitalized on February 15. Following the surgery, the patient was discharged the next day and is poised to embark on her fertility journey soon.
(Input from various sources)
(Rehash/Komal Bhoi/MSM)
References:
https://my.clevelandclinic.org/health/diseases/23302-unicornuate-uterus
https://www.mayoclinic.org/diseases-conditions/adenomyosis/symptoms-causes/syc-20369138
