Laparoscopic Resection of Rudimentary Horn for Treatment of Pelvic Pain

Abstract

<h3>Study Objective</h3> To provide a brief overview of symptomatology of rudimentary uterine horns, as well as to demonstrate a minimally invasive resection of a rudimentary horn for treatment of pelvic pain. <h3>Design</h3> Surgical video. <h3>Setting</h3> Academic tertiary care hospital. <h3>Patients or Participants</h3> 24-year-old G0P0 initially evaluated for worsening menorrhagia and dysmenorrhea. Pelvic MRI showed a unicornuate uterus with a 2.5 cm nondistended noncommunicating right rudimentary horn. <h3>Interventions</h3> A laparoscopic resection of a rudimentary uterine horn was planned. The right pelvic sidewall was opened. The origin of the uterine artery was dissected out and cauterized. The round ligament was divided, and the anterior leaf of the broad ligament was undermined and incised to the end of the rudimentary horn. The right fallopian tube was followed to its fimbriated end, and a total salpingectomy was performed, and the remaining portion of the rudimentary horn was resected. A posterior colpotomy was created, and a specimen retrieval bag was inserted through the colpotomy. The specimen was completely removed in the bag. The colpotomy was then closed in a running fashion. <h3>Measurements and Main Results</h3> The patient was discharged on post operative day zero. She had a follow-up visit after 1 week, meeting all milestones and without complications. Upon long term follow up she reported improved pain. <h3>Conclusion</h3> Uterine rudimentary horns represent a mullerian anomaly that can be associated with cyclic pelvic pain. Laparoscopic resection of rudimentary horn can offer a minimally invasive option for immediate improvement in pelvic pain.