The classical surgical correction of malformations of the mullerian axis has been progressively replaced by operative hysteroscopy and laparoscopy; the performance of hysteroscopic metroplasty, the laparoscopic creation of a neovagina in the M.R.K.II syndrome and the laparoscopic ablation of non- communicating rudimentary uterine horns constitute clear examples. The question is if there are still mullerian anomalies that have to be treated by traditional surgery and therefore if, in particular circumstances, this technique is still valid. Important indications could be bicornuate uterus with a wide angle of divarication of the two hemicavities, occasionally the dydelphis uterus after repeated abortions and the exclusion of other concomitant causes, and the double uterus with imperforate hemivagina and homolateral renal agenesis. We report about 344 cases of mullerian anomalies and their association to urologic anomalies treated from 1962 to 1992 in the department of Obstetric and Gynecology of the University of Milan. With the use of laparotomic metroplasty or endoscopic techniques we obtained the same results in terms of pregnancy rate, in the treatment of septate uteri and the majority of bicornuate uteri. In conclusion, besides particular anomalies that will still benefit from traditional surgery, videosurgery has to be considered the technique of choice in the diagnosis and treatment of mullerina axis'anomalies.
|Number of pages||7|
|Journal||References en Gynecologie Obstetrique|
|Publication status||Published - 1997|
- Mullerian anomalies
- Uterine malformations
ASJC Scopus subject areas
- Obstetrics and Gynaecology