[Laparoscopic hemi-hysterectomy in treatment of a didelphic uterus with a hypoplastic cervix and obstructed hemivagina]

Maldevelopment of the Mullerian duct system may result in various urogenital anomalies including didelphic uterus with a hypoplastic cervix and obstructed hemivagina. We report a patient with this anamoly who was treated by laporoscopic hemi-hysterectomy and hysteroscopic resection of hemivagina. A 16 year old patient who had complained of vaginal pus-like discharge on and off for 1 year was diagnosed by MRI to have a double uterus with obstructed right hemivagina and ipsilateral renal agenesis. After hysteroscopic identification of hypoplasia of the right uterine cervix, laparoscopic resection of the right uterus and right fallopian tube and hysteroscopically assisted resection of the vaginal septa were performed successfully. We think that combined laparoscopy and hysteroscopy may be an efficacious alternative in the management and diagnosis of Mullerian anomalies

[Postmenopausal uterine bleeding. Analytic study about 65 cases]

Postmenopausal uterine bleeding is frequent in gynecology. This symptom can reveal benign causes as well as cancers. So it's essential to rule out organic pathology. We propose a retrospective study of 65 postmenopausal women who had uterine bleeding for two years. To study the relative frequency of different causes of post-menopausal uterine bleeding.- To evaluate the different investigation procedures. In 65 cases of postmenopausal bleeding, we found:- 6 cases of cancer [9.2%]: 4 cases of cancer of uterine corpus and 2 cases of cancer of uterine cervix.- Benign pathology was more frequent [59 cases: 90.8%], essentially represented by endometrial atrophy [37 cases] and hyperplasia [11 cases].- Hysteroscopic aspect in the 4 cases of endometrial cancer:- Polypoid hypertrophy: 2 cases.- Simple hyperplasia: 2 cases. Despite the fact that benign pathology is more frequent than malignancy as a cause postmenopausal uterine bleeding, we must always rule out a cancer by oriented biopsy