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Clinical Reproductive Medicine and Surgery pp 461–485Cite as

Surgical Techniques for Management of Anomalies of the Müllerian Ducts

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Abstract

Anomalies of the Müllerian ducts are common congenital abnormalities that occasionally require surgical intervention for symptom control or improvement in reproductive outcomes. Most women with vaginal agenesis can obtain a functional vagina with mechanical dilation. Rudimentary horns with functional endometrium need to be removed. Most obstructive vaginal abnormalities can be handled with simple surgical excision, although some are complex and require skin grafts. Duplication of the uterus is typically asymptomatic.

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Abbreviations

Müllerian agenesis:

Lack of development or complete resorption of the Müllerian ducts leading to lack of development of a uterus

Cervical agenesis:

Lack of development or incomplete development of the cervix. Patients present with cryptomenorrhea and cyclic pelvic pain

Septate uterus:

Incomplete fusion of the Müllerian ducts leading to persistence of midline tissue in the uterine cavity

Bicornuate uterus:

Incomplete fusion of the Müllerian ducts leading to serosal myometrial invagination of at least 1 cm

Didelphic uterus:

Complete lack of fusion of the Müllerian ducts leading to development of two uteri each with one fallopian tube

Unicornuate uterus:

Development of only one Müllerian duct into its associated uterus and one fallopian tube

Longitudinal vaginal septum:

Results from a lateral fusion defect leading to persistence of longitudinal tissue in the vaginal canal

Transverse vaginal septum:

Results from vertical fusion defect leading to persistence of transverse band of tissue in the vaginal which may be complete or incomplete

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Section of Pediatric and Adolescent Gynecology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Marjan Attaran MD

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  1. Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA

    Tommaso Falcone

  2. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina, USA

    William W. Hurd

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Attaran, M. (2017). Surgical Techniques for Management of Anomalies of the Müllerian Ducts. In: Falcone, T., Hurd, W. (eds) Clinical Reproductive Medicine and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-52210-4_26

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