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Diagnostic hysteroscopy and adenomyosis: the case of a uterine cornual cavern. A video article

Diagnostic hysteroscopy and adenomyosis: the case of a uterine cornual cavern. A video article

J Endometr Pelvic Pain Disord 2017; 9(2): 131 - 131

Article Type: VIDEO ARTICLE

DOI:10.5301/jeppd.5000279

Authors

Ivan Mazzon, Alessandro Favilli, Mario Grasso, Sandro Gerli

Abstract

Introduction

The aim of this study is to show a rare case of adenomyosis presented as a “cavern” which completely involves a uterine cornu.

Case description

A 39-year-old nulliparous patient, with five previous laparoscopic myomectomies during which multiple myomas and adenomyomas have been removed, presented at the Arbor Vitae Centre for Endoscopic Gynaecology in Rome because of an abnormal uterine bleeding. A 6 cm myoma with multiple endometrial glands inside, located on the left uterine cornu, was enucleated during the last procedure. The ultrasound scan showed a 1 cm endometrial polyp and suspected adenomyosis reaching the serosa on the left uterine cornu.

Free-anaesthesia diagnostic hysteroscopy was performed with carbon dioxide as distension medium and using a 30-degree fore-oblique rigid telescope with a diameter of 2.9 mm, covered with a single-flow examination sheath. An electronic hysteroflator was set at a flow rate of 30 mL/min and a maximum intrauterine pressure of 75 mm Hg. Multiple adenomyosis caverns that deepen into the myometrium were found on the left uterine cornu.

Conclusions

Previous multiple myomectomy may seriously alter the internal uterine anatomy, especially in presence of adenomyosis. In case of presence of numerous recesses in the uterine cavity, a suspicion of adenomyosis should be considered.

Article History

Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: IM reports non-financial support from STORZ, Tuttlingen, Germany, outside the submitted work. AF, MG and SG report no conflict of interest.

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Disclosures

Financial support: No grants or funding have been received for this study.
Conflict of interest: IM reports non-financial support from STORZ, Tuttlingen, Germany, outside the submitted work. AF, MG and SG report no conflict of interest.

Authors

Affiliations

  •  “Arbor Vitae” Centre, Clinica Nuova Villa Claudia, Rome - Italy
  •  Department of Obstetrics and Gynaecology, University of Perugia, Perugia - Italy

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