Robert's uterus treated with ultrasound-guided laparoscopy and hysteroscopy: a case report

We report the case of a woman in her early 30 s who was diagnosed with Robert's uterus. She had been experiencing progressive dysmenorrhea for a decade and sought treatment for infertility at our hospital. Preoperative ultrasound imaging resulted in a misdiagnosis of a complete uterine septum with an accompanying ovarian cyst. However, intraoperative ultrasound-guided laparoscopy and hysteroscopy confirmed the presence of an asymmetric mediastinal uterus with a blind cavity, consistent with Robert's uterus, along with endometriosis. We performed a combined hysteroscopy and laparoscopy to excise the septum and endometrial cyst in the uterine cavity, and we inserted a uterine cavity stent to prevent postoperative intrauterine adhesions. Subsequent evaluations confirmed the success of the surgical and postoperative treatment strategies. The findings in this case suggest that despite the risk of a misdiagnosis before surgery, accurate assessment and effective surgical intervention for Robert's uterus can be achieved by the combined application of hysteroscopy and laparoscopy, with guidance by ultrasound. Furthermore, our findings highlight the importance of addressing concurrent conditions in the management of Robert's uterus.