Robert's Uterus-Types, Diagnosis, and Management Options: Case Series and Review of Literature.

Abstract

Objective: To report three cases of Robert's uterus and to describe the types, diagnostic methods, and management options for this rare Mullerian anomaly.

Methods: Three adolescent girls presented with progressive severe dysmenorrhea since menarche. Two girls had undergone inappropriate surgeries due to misdiagnosis in past which did not relieve their symptoms. MRI reported as juvenile cystic adenomyoma (JCA) in one girl and Robert's uterus in other two girls.

Results: All three patients underwent surgical intervention. The first patient underwent laparoscopic blind horn resection and residual myometrial closure. The decision was taken in view of severe symptoms, school dropout, large adenomyotic lesion, and previous one appendicectomy following misdiagnosis, and patient was not willing for any conservative management. The other two patients underwent transabdominal ultrasonography-guided hysteroscopic resection of septum and hematometra drainage. All the patients had relieved from dysmenorrhea and are asymptomatic.

Conclusion: All girls presenting with progressive dysmenorrhea should be evaluated for Mullerian anomalies including the rare ones like Robert's uterus. USG-guided hysteroscopic septal resection may be considered for all cases of Robert's uterus for immediate symptom relief and better future reproductive outcomes. Further long-term follow-up of these patients undergoing conservative surgeries is warranted.