Leiomyoma on the septum of a septate uterus with double cervix and vaginal septum: a challenge to manage

• Published in: Fertility and sterility Vol. 89; no. 2; pp. 456.e3 - 456.e7
• Main Authors: Caliskan, Eray, M.D, Cakiroglu, Yiğit, M.D, Turkoz, Erkan, M.D, Corakci, Aydin, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2008
• Subjects: Adult; Cervix Uteri - abnormalities; Cervix Uteri - surgery; Congenital Abnormalities - surgery; Female; Humans; Hysterosalpingography; Hysteroscopy; Infertility, Female - etiology; Internal Medicine; leiomyoma; Leiomyoma - complications; Leiomyoma - diagnosis; Leiomyoma - surgery; Models, Biological; Müllerian anomaly; Obstetrics and Gynecology; Reconstructive Surgical Procedures; septate uterus; Uterine Neoplasms - complications; Uterine Neoplasms - diagnosis; Uterine Neoplasms - surgery; Uterus - abnormalities; Uterus - surgery; Vagina - abnormalities; Vagina - surgery; vaginal septum; Müllerian anomaly; vaginal septum; septate uterus; leiomyoma
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2007.03.045

Objective To describe the first case of a leiomyoma localized in the septum of a septate uterus that had cervical duplication and a longitudinal vaginal septum. Design Case report. Setting A university hospital. Patient(s) A 43-year-old patient with primary infertility and complaint of menorrhagia. Intervention(s) Laparotomy, adhesiolysis, myomectomy, and resection of the vaginal septum in the first operation. Hysteroscopic resection of the complete uterine septum in the second operation. Main Outcome Measure(s) Magnetic resonance imaging findings and two-step repair of the anomaly. Cervical length at second trimester. Result(s) Restoration of normal anatomy was achieved after correct diagnosis and a two-step operation procedure. A normal cervical length was measured at 26 weeks of gestation. Conclusion(s) Large leiomyoma at rare localizations in the presence of uterine anomalies is a diagnostic challenge, but with available diagnostic technology and appropriate operations, successful results can be obtained.