Rare variant of unicornuate uterus with functional uterine horn and ipsilateral renal agenesis: a case report

In: Thai Journal of Obstetrics and Gynaecology · 2026 · pp. 417–423 · doi:10.66650/tjog.v34i5.281434 · W7219694960
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Diagnostic laparoscopy confirmed a unicornuate uterus with a non-communicating functional horn and ipsilateral renal agenesis in a 12-year-old girl, leading to surgical removal of the rudimentary horn and an associated endometriotic cyst.

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This case report describes a 12-year-old girl presenting with severe dysmenorrhea and abdominal pain, initially diagnosed via imaging as having a bicornuate uterus with hematometra. Diagnostic laparoscopy revealed a right unicornuate uterus with a non-communicating functional left horn, ipsilateral renal agenesis, and an endometriotic cyst. Surgical excision of the rudimentary horn and associated pathology resolved the patient's symptoms and confirmed the anatomical anomaly. Relevance to endometriosis: The paper documents the surgical removal of an endometriotic cyst found incidentally during the management of a Müllerian duct anomaly, linking the condition as a comorbid finding in this specific clinical scenario.

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Abstract

Background: A unicornuate uterus is a rare congenital malformation of the Mullerian duct caused by incomplete development of one duct, often associated with obstructive complications and renal anomalies. Case presentation: A 12-year-old girl reported progressive left-sided lower abdominal pain and cyclical dysmenorrhea unresponsive to analgesics. Ultrasonography revealed hematometra, hematocolpos, and an absent left kidney. While MRI indicated a bicornuate uterus with hematometra, hematosalpinx, and a possible left endometriotic cyst, vaginoscopy showed a single right-sided cervix, ruling out hematocolpos. Diagnostic laparoscopy confirmed a right unicornuate uterus with a non-communicating functional left uterine horn, along with a left hematosalpinx and an endometriotic cyst. Surgical removal of the rudimentary horn, hematosalpinx, and endometriotic cyst was performed. The patient recovered well with relief of pain in subsequent menstrual cycles. Conclusion: Early Ultrasound and MRI may facilitate the diagnosis, but laparoscopy provides definitive evaluation and management of such a rare congenital anomaly while preserving long-term reproductive health.
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Abstract

Background: A unicornuate uterus is a rare congenital malformation of the Mullerian duct caused by incomplete development of one duct, often associated with obstructive complications and renal anomalies. Case presentation: A 12-year-old girl reported progressive left-sided lower abdominal pain and cyclical dysmenorrhea unresponsive to analgesics. Ultrasonography revealed hematometra, hematocolpos, and an absent left kidney. While MRI indicated a bicornuate uterus with hematometra, hematosalpinx, and a possible left endometriotic cyst, vaginoscopy showed a single right-sided cervix, ruling out hematocolpos. Diagnostic laparoscopy confirmed a right unicornuate uterus with a non-communicating functional left uterine horn, along with a left hematosalpinx and an endometriotic cyst. Surgical removal of the rudimentary horn, hematosalpinx, and endometriotic cyst was performed. The patient recovered well with relief of pain in subsequent menstrual cycles.

Conclusion

Early Ultrasound and MRI may facilitate the diagnosis, but laparoscopy provides definitive evaluation and management of such a rare congenital anomaly while preserving long-term reproductive health. Article Details This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

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