PMC10331220_01
Pelvic MRI in T2 showing a solid organ between the bladder and the rectum, with the usual appearance of the anteverted uterus. The arrow points to its posterior end.
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Mullerian malformation was then considered. Magnetic resonance imaging of the pelvis was conducted (Figure 1) and a structure resembling a rudimentary uterus with vaginal canal and ovary was described by the radiologist.
Laparoscopic approach to the uterus site. The uterus corpus (indicated by the black asterisk) is seen as eutrophic, attached to the abdominal cavity through a peritoneum-like membrane. The left fallopian tube is also visible (indicated by the solid arrow), including attached yellowish adipose tissue.
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The preferred surgical approach is a laparoscopic radical hysterectomy (see Figures 2-5), which contemplates the removal of the uterus, fallopian tubes, the only formed right ovary, cervix, vaginal canal and appendages, which were later confirmed by anatomopathological examination and showed no signs of cellular atypia or neoplastic transformations.
Following the cervix, an incision was performed in the membrane to expose the vaginal cul-de-sac (indicated by the black star), which is grappled by the surgeon.
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The preferred surgical approach is a laparoscopic radical hysterectomy (see Figures 2-5), which contemplates the removal of the uterus, fallopian tubes, the only formed right ovary, cervix, vaginal canal and appendages, which were later confirmed by anatomopathological examination and showed no signs of cellular atypia or neoplastic transformations.
Soon after exposing the vaginal cul-de-sac. Because of the dissection, it is possible to determine its limits and proceed with extirpation. The vaginal canal is then extorted from the attached connective tissue and removed.
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fig4-26330040231184484
The preferred surgical approach is a laparoscopic radical hysterectomy (see Figures 2-5), which contemplates the removal of the uterus, fallopian tubes, the only formed right ovary, cervix, vaginal canal and appendages, which were later confirmed by anatomopathological examination and showed no signs of cellular atypia or neoplastic transformations.
Exploring the dissected vaginal canal to determine its end (cul-de-sac). The whitish fibrous tissue seen (indicated by the dotted arrow) represents a fusion of connective tissue, resembling fibrosis, and closes the vaginal canal where the vulva should be in women.
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fig5-26330040231184484
The preferred surgical approach is a laparoscopic radical hysterectomy (see Figures 2-5), which contemplates the removal of the uterus, fallopian tubes, the only formed right ovary, cervix, vaginal canal and appendages, which were later confirmed by anatomopathological examination and showed no signs of cellular atypia or neoplastic transformations.