Rare medical case: Indian woman with half uterus treated successfully

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In a groundbreaking medical achievement, doctors here on Thursday said they have successfully treated an extremely rare case of half uterus, known as adenomyosis in a non-communicating rudimentary horn -- the first-ever in India.

"This case is the second reported worldwide, with the first case documented at the Lebanese American University Center in July 2021," said doctors at C.K. Birla Hospital, Gurugram, in a statement.

The patient, a 27-year-old woman, sought medical attention due to pelvic pressure, constant pain on the right side of her lower abdomen and pelvis. She was also unable to conceive.

Clinical examinations revealed a large firm lump which deviated to the right side of the lower abdomen. The doctors initially suspected a fibroid. But detailed diagnostic hysteroscopy and robotic myomectomy (adenomyoma removal) with chromopertubation revealed that the woman had a left unicornuate uterus with adenomyosis in the non-communicating right horn, attached to a large fibroid-like mass.

This challenging anomaly required meticulous dissection and extraction, taking care to preserve surrounding structures like the intestines and urinary bladder, the doctors said.

"The adenomyoma in the non-communicating horn presented a unique challenge. With careful dissection, we successfully removed the adenomyoma, saving the ureter on the right side. The rarity of a functioning non-communicating rudimentary horn, coupled with adenomyosis, makes this case exceptional. The successful treatment involved a complete robotic-assisted excision of the entire horn, leading to significant improvement in the patient's condition," Dr Aruna Kalra, Director, Obstetrics and Gynaecology, at the hospital, said.

"The final histopathology confirmed the presence of adenomyosis in the rudimentary horn, adding a valuable contribution to the limited cases reported globally. The clinical presentation of such cases can vary from mild pain to complications such as pelvic pain, endometriosis, or obstetrical issues like preterm delivery and ectopic pregnancy," Dr Kalra added.

The patient was discharged the next day and is expected to begin her fertility journey soon, the doctor said.

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