Abstract
Objective
To investigate the clinical characteristics and individualized hysteroscopic conservative treatment strategies for a case of uterine didelphys with a single vagina complicated by bilateral adenomyosis, adenomyoma, and endometrial polyps.
Methods
A retrospective analysis was conducted on the clinical data of a reproductive-aged female patient admitted to Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine. The patient’s medical history, imaging features, surgical approach, and follow-up outcomes were systematically reviewed and analyzed in conjunction with relevant literature.
Results
The patient presented with progressively worsening dysmenorrhea and menorrhagia. Imaging revealed uterine didelphys (single vaginal type) with bilateral diffuse adenomyosis and adenomyoma, accompanied by endometrial polyps. Hysteroscopic polypectomy was performed. Based on the morphology of both uterine cavities and the characteristics of the lesions, a levonorgestrel-releasing intrauterine system was suture-fixed hysteroscopically in the right uterine cavity, while a GyneFix
®
IUD was placed in the left cavity. At the 12-month follow-up, the patient’s dysmenorrhea VAS score decreased from 9 to 2, and the pictorial blood loss assessment chart (PBAC) score decreased from 280 to 35, with no device expulsion or lesion recurrence observed.
Conclusion
Hysteroscopic individualized selection and suture fixation of intrauterine devices can serve as an effective uterus-preserving treatment option for patients with complex uterine anomalies complicated by adenomyosis.