What is uterine curvature?

Uterine curvature is also called uterine malformation. It is a congenital dysplasia and a relatively small uterus. Such patients often have irregular and abnormal menstruation. It also includes the absence of a uterus or a broken and incomplete uterus. You need to pay attention to these symptoms in normal times and choose the appropriate treatment method according to your personal physical condition.

Treatment

An underdeveloped or underdeveloped uterus

(1) Congenital absence of uterus is caused by the failure of fusion and regression of the uterine segments formed by the bilateral paramesonephric ducts. Often associated with absence of vagina.

(2) Primordial uterus The primordial uterus stops developing soon after the fusion of the bilateral mesonephric ducts. The uterus is extremely small and most of them have no uterine cavity or are a solid muscular uterus. Occasionally, a primordial uterus can be seen with a uterine cavity and endometrium.

(3) The immature uterus is caused by the fusion of the bilateral mesonephric ducts to form the uterus and then the uterus stops developing. The uterine body is small and may have a uterine cavity and endometrium.

(4) Congenital absence of uterus or solid primordial uterus is asymptomatic, but there is no menstruation after puberty and it can only be discovered during examination. If the primordial uterus with a uterine cavity and endometrium has an atresia of the uterine cavity or no vagina, periodic abdominal pain may occur due to retention or backflow of menstrual blood. The immature uterus has infrequent menstruation, and examination shows that the uterus is small and the cervix is ​​relatively long.

(5) Patients with no uterus/solid primordial uterus do not need to be treated. Patients with primordial uterus and periodic abdominal pain or intrauterine blood need surgical removal of the primordial uterus. For immature uterus, sequential cyclical treatment with estrogen plus progestin is recommended.

Unicornuate uterus and rudimentary horn uterus

(1) In a unicornuate uterus, only one side of the paramesonephric duct develops normally to form a unicornuate uterus, while the other side of the paramesonephric duct does not develop at all or forms a tube. The ovary, fallopian tube and kidney on the undeveloped side are often the same at the same time.

(2) The middle and lower segments of the paramesonephric duct on one side of the rudimentary horn of the uterus are developmentally defective, forming a rudimentary horn of the uterus. The rudimentary horn of the uterus has normal ovaries and fallopian tubes, often accompanied by abnormal development of the urinary system organs on the same side. It often exists at the same time as unicornuate uterus, accounting for about 65%. The paramesonephric duct on one side develops into a unicornuate uterus, and the middle and lower segments of the paramesonephric duct on the other side develop defects, forming a rudimentary horn of the uterus. According to the anatomical relationship between the rudimentary horn and the unicornuate uterus, it can be divided into three types: Type I rudimentary horn has a uterine cavity, which is connected to the unicornuate uterus; Type II rudimentary horn has a uterine cavity, but is not connected to the unicornuate uterus; Type III rudimentary horn is a solid rudimentary horn, which is only connected to the unicornuate uterus by a fibrous band.

(3) Clinical manifestations: Unicornuate uterus is asymptomatic. If the rudimentary horn of the uterus has endometrial function and the uterine cavity is not connected to the unicornuate uterine cavity, dysmenorrhea often occurs due to retrograde menstrual blood or blood accumulation in the uterine cavity, and endometriosis may also occur. Examination showed that the unicornuate uterus was small and deviated from the midline. In patients with a rudimentary horn of the uterus, a small hard mass may be felt on the other side of the uterus. If there is blood accumulation in the uterine cavity of the rudimentary horn of the uterus, a mass may be felt and there may be tenderness.

(4) No treatment is required for unicornuate uterus, but intensive monitoring is required during pregnancy to prevent uterine torsion, etc. The treatment of rudimentary horn of the uterus varies according to its type. If it is type I rudimentary horn of the uterus, it may not be treated if there are no symptoms. Type II rudimentary horn of the uterus often has symptoms such as dysmenorrhea and requires surgical removal of the uterine body. During the operation, the fallopian tube on the same side needs to be removed at the same time to avoid tubal pregnancy. Type III rudimentary horn of the uterus is asymptomatic and does not require treatment.