Uterine rudiments: clinical and morphological options of surgical treatment and its optimization


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Abstract

Objective. To optimize surgical treatment for complete or asymmetric aplasia of the uterus. Subjects and methods. A total of 95 patients with aplasia of the uterus and vagina, as well as with uterus unicornis were examined and operated on at the Department of Operative Gynecology, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, in the period f2016 to 2019. A complete clinical and laboratory examination, including ultrasound study of the pelvic organs and urinary system, was performed. Results. Surgical treatment was performed according to patient complaints and the identified type of anomaly on the basis of clinical recommendations. Uterine rudiments during complete symmetric (aplasia of the uterus and vagina) and asymmetric (unicornuate uterus) malformations had a certain proliferative potential, as confirmed by clinical cases of growth and manifestation of functional activity; leiomyoma; and the presence of endometrioid heterotopias in the absence of eutopic (normal) endometrium. Conclusion. To optimize surgical treatment, it is expedient to verify the clinical and anatomical options, to assess a risk for potential growth of pluripotent cells, and to expand indications for surgical removal of uterine rudiments in order to prevent complications.

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About the authors

Zohrab N. Makiyan

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: makiyan@mail.ru

Leyla V. Adamyan

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: aleyla@inbox.ru

Alexandra V. Asaturova

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Nadezhda K. Yarygina

Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: n.yarygina@gmail.com

References

  1. Адамян Л.В., Курило Л.Ф., Глыбина Т.М., Окулов А.Б., Макиян З.Н. Аномалии развития органов женской репродуктивной системы: новый взгляд на морфогенез. Проблемы репродукции. 2009; 15(4): 10-9. [Adamyan L.V., Kurilo L.F., Glybina T.M., Okulov A.B., Makiyan Z.N. Anomalii razvitiya organov zhenskoi reproduktivnoi sistemy: novyi vzglyad na morfogenez. Problemy reproduktsii/Russian Journal of Human Reproduction. 2009; 15(4): 10-9. (in Russian)]
  2. Адамян Л.В., Богданова Е.А., Степанян А.А., Окулов А.Б, Глыбина Т.М., Макиян З.Н., Курило Л.Ф. Аномалии развития женских половых органов: вопросы идентификации и классификации (обзор литературы). Проблемы репродукции. 2010; 16(2): 7-15.
  3. Grimbizis G.F., Gordts S., Di Spiezio Sardo A., Brucker S., De Angelis C., Gergolet M. et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum. Reprod. 2013; 28(8): 2032-44. https:// dx.doi.org/10.1093/humrep/det098.
  4. Makiyan Z. New theory of uterovaginal embryogenesis. Organogenesis. 2016; 12(1): 33-41. https://dx.doi.org/10.1080/15476278.2016.1145317.
  5. Окулов А.Б., Магомедов М.П., Поддубный И.В., Богданова Е.А., Файзулин А.К., Макиян З.Н., Глыбина Т.М., Смирнов В.Ф., Володько Е.А., Мираков К.К., Бровин Д.Н. Синдром Майера-Рокитанского-Кюстера-Хаузера у девочек, его варианты. Органосохраняющая тактика лечения. Андрология и генитальная хирургия. 2007; 8(4): 45-52.
  6. Макиян З.Н., Адамян Л.В., Быченко В.Г., Мирошникова Н.А., Козлова А.В. Функциональная магнитно-резонансная томография для определения кровотока при симметричных аномалиях матки. Акушерство и гинекология. 2016; 10: 73-9.
  7. Адамян Л.В., Фархат К.Н., Макиян З.Н. Комплексный подход к диагностике, хирургической коррекции и реабилитации больных при сочетании аномалий развития матки и влагалища с эндометриозом. Проблемы репродукции. 2016; 22(3): 84-90.
  8. Acien P., Sanchez del Campo F., Mayol M.J., Acien M. The female gubernaculum: role in the embryology and development of the genital tract and in the possible genesis of malformations. Eur. J. Obstet. Gynecol. Reprod. Biol. 2011; 159(2): 426-32. https://dx.doi.org/10.1016/j.ejogrb.2011.07.040.
  9. Acien P., Acien M. Unilateral renal agenesis and female genital tract pathologies. Acta Obstet. Gynecol. Scand. 2010; 89(11): 1424-31. https://dx.doi.org/10.31 09/00016349.2010.512067.
  10. Acien P., Acien M. The history of female genital tract malformation classifications and proposal of an updated system. Hum. Reprod. Update. 2011; 17(5): 693- 705. https://dx.doi.org/10.1093/humupd/dmr021.
  11. Acien P., Acien M. The presentation and management of complex female genital malformations. Hum. Reprod. Update. 2016; 22(1): 48-69. https://dx.doi. org/10.1093/humupd/dmv048.
  12. Dragusin R., Tudorace S., Surlin V. Importance of laparoscopic assessment of the uterine adnexa in a Mayer-Rokitansky-Kuster-Hauser syndrome type II case. Curr. Health Sci. J. 2014; 40(2): 144-7. https://dx.doi.org/10.12865/ CHSJ.40.02.13.
  13. Fletcher H.M., Campbell-Simpson K., Walcott D., Harriott J. Mullerian remnant leiomyomas in women with Mayer-Rokitansky-Kuster-Hauser syndrome. Obstet. Gynecol. 2012; 119(2, Pt 2): 483-5. https://dx.doi. org/10.1097/A0G.0b013e318242a9b5.
  14. Oppelt P.G., Lermann J., Strick R., Dittrich R., Strissel P., Rettig I. et al. Malformations in a cohort of 284 women with Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH). Reprod. Biol. Endocrinol. 2012; 10: 57-64. https://dx.doi.org/10.1186/1477-7827-10-57.
  15. Rousset P., Raudrant D., Peyron N., Buy J.N., Valette P.J., Hoeffel C. Ultrasonography and MRI features of the Mayer-Rokitansky-Kuster-Hauser syndrome. Clin. Radiol. 2013; 68(9): 945-52. https://dx.doi. org/10.1016/j. crad.2013.04.005.
  16. Kawano Y., Hirakawa T., Nishida M., Yuge A., Yano M., Nasu K., Narahara H. Functioning endometrium and endometrioma in a patient with Mayer-Rokitanski-Kuster-Hauser syndrome. Jpn. Clin. Med. 2014; 5: 43-5. https:// dx.doi.org/10.4137/JCM.S12611.
  17. Makiyan Z. Endometriosis origin from primordial germ cells. Organogenesis. 2017; 13(3): 95-102. https://dx.doi.org/10.1080/15476278.2017.1323162.
  18. Venetis C.A., Papadopoulos S.P., Campo R., Gordts S., Tarlatzis B.C., Grimbizis G.F. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod. Biomed. Online. 2014; 29(6): 665-83. https:// dx.doi.org/10.1016/j.rbmo.2014.09.006.
  19. Signorile P.G., Baldi A. Endometriosis: New concepts in the pathogenesis. Int. J. Biochem. Cell Biol. 2010; 42(6): 778-80. https://dx.doi.org/10.1016/j. biocel.2010.03.008.
  20. Signorile P.G., Baldi F., Bussani R., D’Armiento M.R., De Falco M., Boccellino M., Quagliuolo L., Baldi A. New evidence sustaining the presence of endometriosis in the human foetus. Reprod. Biomed. Online. 2010; 21(1): 142-7. https://dx.doi. org/10.1016/j.rbmo.2010.04.002.

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