Ultrasound combined with hysteroscopy for optimum treatment of Robert's uterus: a case report and a review

BMC Womens Health. 2022 Aug 7;22(1):334. doi: 10.1186/s12905-022-01903-x.

Abstract

Background: Rbert's uterus, also known as asymmetric septate uterus, is a rare genital malformation first reported by Dr. Robert in 1970. Robert's uterus is characterized by a septate uterus with a blind hemicavity and an intact external fundus. According to some reports, Robert's uterus was typically managed by laparoscopic uterine resection of a hemicavity, laparoscopic endometrectomy, and even hysterectomy. Considering that fertility preservation is important in young patients, we recommend ultrasound-guided hysteroscopic septum resection as an optimum treatment for Robert's uterus.

Case presentation: Herein is described a clinical case of Robert's uterus in a 15-year-old girl who was misdiagnosed for primary dysmenorrhea in the beginning. Magnetic resonance imaging (MRI) and 3-dimensional (3D) ultrasound identified an asymmetrical uterine septum. The patient was treated using ultrasound-guided hysteroscopic treatment without laparoscopy. The surgical procedure lasted less than an hour, and the symptoms of dysmenorrhea were relieved during a six months follow-up.

Conclusions: Ultrasound-guided hysteroscopic septum resection is the preferred treatment for Robert's uterus.

Keywords: Hysteroscopy; Laparoscopy; Malformation; Robert’s uterus; Ultrasound.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Dysmenorrhea / etiology
  • Dysmenorrhea / pathology
  • Dysmenorrhea / surgery
  • Female
  • Humans
  • Hysteroscopy* / methods
  • Laparoscopy* / methods
  • Pregnancy
  • Ultrasonography / methods
  • Uterus / diagnostic imaging
  • Uterus / surgery