Laparoscopic Strassman’s metroplasty for bicornuate uterus – is it relevant?

The mean incidence of bicornuate uterus in Mullerian duct anomalies is approximately 25%, and it is associated with abortion, preterm delivery and term delivery rates of 36%, 23% and 40.6%,respectively. Open abdominal metroplasty has been shown to significantly improve pregnancy outcomes in patients with bicornuate uterus. However, minimally invasive laparoscopic metroplasty could be an alternative. A 24-year-old woman with a bicornuate uterus and poor reproductive outcomes underwent laparoscopic Strassman’s metroplasty. The procedure was completed safely within 180 minutes with minimum blood loss. At follow-up hysteroscopy and laparoscopy 2 months later, minimal adhesions in the pelvis were noted and removed. There were no synechiae in the uterine cavity. It is concluded that laparoscopic metroplasty is a safe and relevant alternative to conventional abdominal metroplasty, with minimal adhesion formation. S Afr J OG 2012;18(3):85-87. DOI:10.7196/SAJOG.565