Uterovaginal canalization and endometrial ablation of the obstructed uterine horn with hypoplastic cervix in the didelphic uterus

Maldevelopment of the mullerian duct system may result in various urogenita l anomalies including didelphic uterus with a hypoplastic cervix. Two women with this anomaly experienced symptoms including recurrent lower abdominal pain off and on of 1 to 2 years' duration. Magnetic resonance imaging reve aled a double uterus with right hematometrium both patients. After hysteros copic identification of hypoplasia of right uterine cervix, laparoscopic re section of the hematosalpinx, followed by uterovaginal canalization and pro phylactic endometrial ablation of the right uterus was successfully perform ed by resectoscope. Normal menstruation ensued during follow-up of 18 and 2 4 months, respectively. Our experience suggests that uterovaginal canalizat ion with prophylactic endometrial ablation may be an efficacious alternativ e to hysterectomy for management of didelphic uterus with a hypoplastic cer vix.