Robert's uterus with delayed diagnosis and potential consequences: a case report

Abstract

A 24-year-old woman who wished to become pregnant presented to our hospital with an enlarged ovarian endometrioma and developmental abnormality of the uterus. Robert's uterus complicated by hematosalpinx, ovarian endometrioma, and endometriosis were finally identified 1 year after previously being diagnosed with a cyst and uterine abnormality at a local hospital. The function of the salpinx and the pelvic environment were damaged because of the delayed diagnosis and operation. Gynecologists and sonologists should be aware of and alert to this rare entity while evaluating and managing cases of uterine abnormalities and endometriosis. Prompt early diagnosis and proper management of Robert's uterus are important for avoiding future morbidity because these are major factors in protecting fertility.

Keywords: Endometriosis; Robert’s uterus; fertility; hematometra; hematosalpinx; ovarian endometrioma.

Figure 1.

Uterus with hematometra (red arrow) in the right uterine hemicavity on three-dimensional ultrasound before surgery (a). An obvious bulge in the right fundus was observed by laparoscopy (red arrow) (b). Hysteroscopy before (c) and after (d) incision of an asymmetric septum (black arrows). Three-dimensional ultrasound examination 1 month after surgery shows an enlarged cavity (e). A mini-hysteroscopy (2.9 mm in diameter) examination 1 month after surgery shows a uterine cavity with a bulge (f).