Facts, Views & Vision
in ObGyn

Journal of the European Society for Gynaecological Endoscopy

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Critical Role of 3D ultrasound in the diagnosis and management of Robert’s uterus: a single-centre case series and a review

M. Deenadayal 1, V. Günther 2, I. Alkatout 2, D. Freytag 2, A. Deenadayal-Mettler 2, A. Deenadayal Tolani 1, R. Sinha 3, L. Mettler 2

1 Mamata Fertility Hospital, 9-1-192, St Marys Rd, Telangana 500003, Hyderabad, India;
2 Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105 Kiel, Germany;
3 Apollo Health City, Gynaecology, Road No 72, Hyderabad, Telangana 500033, Hyderabad, India.

Keywords:

Robert’s uterus, congenital uterine anomalies, laparoscopy, hysteroscopy


Published online: Mar 31 2021

https://doi.org/10.52054/FVVO.13.1.008

Abstract

A septate uterus with a non-communicating hemicavity was first described by Robert in 1969/70 as a specific malformation of the uterus. The condition is commonly associated with a blind uterine hemicavity, unilateral haematometra, a contralateral unicornuate uterine cavity and a normal external uterine fundus. The main symptoms are repetitive attacks of pain at four-weekly intervals around menarche, repeated dysmenorrhea, recurrent pregnancy loss and infertility.

In this report, we review the disease, its diagnosis and treatment, and describe five cases of Robert’s uterus. Three dimensional (3D) ultrasound (US) imaging was performed by the transvaginal route in four cases. In the fifth case of a 13-year-old girl, we avoided the vaginal route and magnetic resonance imaging (MRI) and 3D transrectal US yielded the correct diagnosis.

The following treatment procedures were undertaken: laparoscopic endometrectomy, hysteroscopic septum resection, laparoscopic uterine hemicavity resection and total laparoscopic hysterectomy (TLH). The diagnosis and optimum treatment of Robert’s uterus remains difficult for clinicians because of its rarity. A detailed and careful assessment by 3D US should be performed, followed by hysteroscopy in combination with laparoscopy, to confirm the diagnosis.