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Should laparoscopy be used in uterine didelphys and obstructed hemivagina? (Checking for Endometriosis).
MIAMI BEACH - Physicians should consider performing a laparoscopy to look for endometriosis in patients with uterine didelphys and obstructed hemivagina, Dr. Michal Yaron advised.
"Not everyone would agree with me on this, but I feel that the incidence of endometriosis is very high in these patients. If you are putting them under general anesthetic to surgically correct their uterine anomaly it is not much more invasive to also perform a laparoscopy looking for endometriosis and removing any that you find," Dr. Yaron said at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.
She presented a 20-year retrospective chart review of 14 patients presenting with uterine didelphys and obstructed hemivagina. The most prevalent complaint was increasing dysmenorrhea, which was present in almost 80% of the patients.
'Abdominal and pelvic pain were also common. One patient complained more of lower back pain, one of vulvodynia, and one had difficulty voiding," said Dr. Yaron, a clinical fellow in obstetrics and gynecology at the Hospital for Sick Children in Toronto.
Patients ranged in age from 12 to 19 years. The time from menarche to presentation was 1 year in more than half of patients, with a range of 3 months to 7 years. Clinical signs included vaginal fullness, ruptured hematocolpos, pyometra, and pelvic masses.
"Some lateral communication can exist between the two uterine bodies or through the longitudinal vaginal septum, which can delay presentation," she explained in an interview.
Imaging studies were done in all patients preoperatively: 13 patients received abdominal ultrasound, 4 ...
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Source: HighBeam Research, Should laparoscopy be used in uterine didelphys and obstructed...