Laparoscopic hemi-hysterectomy in treatment of a didelphic uterus with a hypoplastic cervix and obstructed hemivagina

Maldevelopment of the Mullerian duct system may result in various urogenita l anomalies including didelphic uterus with a hypoplastic cervix and obstru cted hemivagina. We report a patient with this anomaly who was treated by l aparoscopic hemi-hysterectomy and hysteroscopic resection of hemivagina. A 17 year old patient who had complained of vaginal pus-like discharge on and off for 1 year was diagnosed by MRI to have a double uterus with obstructe d right hemivagina and ipsilateral renal agenesis, After hysteroscopic iden tification of hypoplasia of the right uterine cervix, laparoscopic resectio n of the right uterus and right Fallopian tube and hysteroscopically assist ed resection of the vaginal septa were performed successfully. From our exp erience, combined laparoscopy and hysteroscopy may be an efficacious altern ative in the management and diagnosis of Mullerian anomalies.