Page 10 - Jcog-October 2017
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J Cases Obstet Gynecol, 2017;4(4):87-90

                                                                                                                                      J o u r n a l   o f   C a s e s   i n
                                                                                                                                      Obs tetrics & G ynecology
                                                                                                                                   Case Report

                                                                                                                                   Dysmenorrhea in association with non-communicating rudimentary uter-
                                                                                                                                   ine horn of a unicornuate uterus: Case report

                                                                                                                                   Nilufer AKGUN , Esra AKTEPE KESKIN , Huseyin Levent KESKIN 3
                                                                                                                                   1 Department of Obstetrics and Gynecology, Medicine School of Koc University Hospital , İstanbul Turkey
                                                                                                                                   2 Department of Obstetrics and Gynecology, Medikal Park Hospital, Ankara, Turkey
                                                                                                                                   3 Department of Obstetrics and Gynecology, Ataturk Education and Research Hospital, Ankara, Turkey


                                                                                                                                   One of the most frequent reasons of pelvic pain is dysmenorrhea. It not only decries patients  daily of life but also results in activity of restric-
                                                                                                                                   tion. Although a physical examination, including a pelvic examination in patients may reveal the cause, preoperative diagnosis of such cases can
                                                                                                                                   be challenging and they also can be miss-diagnosed occasionally and thus could be led into bigger problems in the post period time. In this study,
                                                                                                                                   we report the case of an 18-year-old adolescent who had recurrent pelvic pain regularly at the time of menses as well as routine menstrual cy-
                                                                                                                                   cle complaints. The patient underwent ultrasonography and magnetic resonance (MRI) imaging of the pelvis. The diagnosis was non communi-
                                                                                                                                   cating rudimentary uterine horn of a unicornuate uterus with two cervix according to test results. An urgent laparoscopy was performed and the
                                                                                                                                   symptoms  and  complaints  were perished  after  the  successful  surgery. Diagnosis and  management  of this  congenital  anomaly  was a  challeng-
                                                                                                                                   ing  issue  due  to  the  complexity  of  the  anatomic  structures,  nonspecific  disagreements,  and  heterogenic  presentation. The  purpose  of  this  paper
                                                                                                                                   is to clarify the diagnosis and therapy choices which could be remedy for this rare condition, moreover, to increase awareness of dysmenorrhea.

                                                                                                                                   Key Words:
                                                                                                                                   Uterus rudimentary horn, müllerian anomalies, dysmenorrhea

                                                                                                                                   Introduction                                            ues after menstruation as a result of persistence to non-ste-
                                                                                                                                                                                           roidal anti-inflammatory analgesics and oral contraceptives.
                                                                                                                                   Dysmenorrhea occurs in painful cramps during men-       Seconder  dysmenorrhea  depends on  some  crucial  caus-
                                                                                                                                   struation [1]. Reported prevalence  is 16.8%-81% in     es such as endometriosis, uterine myoma, adenomyosis,
                                                                                                                                   overall, even some reports can be up to 90% while ado-  uterine and vaginal anomalies causing menstrual outflow
                                                                                                                                   lescents  with  severe  dysmenorrhea  is 42% [2].   Dys-  obstruction  [3]. Congenital  abnormalities  in the mulleri-
                                                                                                                                   menorrhea  can  be  categorized  into  two  groups;  first   an duct accompany with dysmenorrhea along with trans-
                                                                                                                                   one  is  no  pelvic  pathology  before  revealed    and  sec-  verse septum of the vagina, cervical atresia, imperforated
                                                                                                                                   ond  one  is  resulting  from  identifiable  organic  diseases.  hymen  and rudimentary  horn besides  unicorn  unite  uter-
                                                                                                                                    Secondary dysmenorrhea develops with the beginning of   us [4].  The European Society of Human Reproduction
                                                                                                                                   pain in 7th- 14th days before menstruation, the pain contin-  and Embryology (ESHRE) and the European Society for
                                                                                                                                                                                           Gynaecological  Endoscopy (ESGE) represented the clas-
                                                                                                                                                                                           sification  system  based  on  anatomic  uterine  anomalies
                                                                                                                                   Article History:
                                                                                                                                   Received: 22/05/2016                                    with or without anomalies of vagina, cervix in 2013  [5].
                                                                                                                                   Accepted: 21/09/2017                                    All cases of hemi-uterus along with unilateral development
                                                                                                                                                                                           of the uterus and the contralateral part, which could be either
                                                                                                                                   *Correspondence: Nilufer Akgun
                                                                                                                                   Address: Kilitbahir street, Begonya Blok, 2 D 11  No: 4  Atakoy 11. Stage  incompletely formed or absent are included in class U4 ac-
                                                                                                                                   Bakırkoy/ Istanbul, Turkey , Postal Code :34158         cording to classification system of ESHRE and ESGE. Rel-
                                                                                                                                   Tel: +90 505 9180299  Fax: +90 2123113410
                                                                                                                                   e-mail:                      evant class is subdivided into two sub-classes depending on

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