Unicornuate uterus associated with retrosigmoid ovary and unilateral renal agenesis: a case report and a review of the literature

Abstract

Unicornuate uterus is a malformation characterized by the unilateral development of a single Müllerian duct during embryogenesis, while the contralateral part is either incompletely developed or absent. It can be associated with a symptomatic presentation, namely chronic cyclic pain, and with adverse reproductive and obstetric outcomes. Transvaginal ultrasound examination, sometimes requiring 3D imaging, is used to diagnose and classify this condition; further investigation may include magnetic resonance imaging (MRI). In this report, we present the case of a healthy 22-year-old woman reporting irregular menstrual cycles who underwent transvaginal ultrasound examination at our obstetrics and gynecology unit. Ultrasonography revealed a unicornuate uterus with absence of rudimentary horn and ipsilateral adnexa in the pelvis. MRI was requested, and showed the presence of a normal ovary located in an ectopic retrosigmoid location, and ipsilateral renal agenesis. These abnormalities may quite frequently occur in the presence of uterine malformations such as unicornuate uterus. A correct classification of such defects and the associated abnormalities is needed in order to be able to counsel patients about potential issues regarding fertility and preservation of renal function, and to discuss the possibility of medical or surgical management of symptoms or associated complications.