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Navigating Complexity: Advanced Visualization for Müllerian Anomalies and its Implications for Diagnoses and Surgical
Anat From1, Tania Dumont1, Sukhbir Singh2
1Department of Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Ontario, Canada; Department of Surgery, CHEO, Ottawa, Ontario, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Journal of Pediatric and Adolescent Gynecology
|June 21, 2025
Summary
Three-dimensional (3-D) modeling and virtual reality (VR) visualization of obstructive Müllerian anomalies improve surgical planning and patient counseling. Prospective VR use can enhance resident education and operative safety for complex cases.
Area of Science:
- Reproductive Medicine
- Surgical Planning
- Medical Imaging
Background:
- Obstructive Müllerian anomalies pose significant diagnostic and surgical challenges, often necessitating extensive imaging and prolonged management.
- Three-dimensional (3-D) modeling and virtual reality (VR) visualization offer potential improvements in understanding complex anatomy, patient counseling, and operative safety.
Observation:
- A patient with primary amenorrhea and cyclic pain underwent extensive imaging over seven years, revealing complete proximal vaginal agenesis, a unicornuate uterus, a rudimentary horn, and obstructive hematometra.
- Despite medical management, severe pain persisted, leading to multidisciplinary consultations and eventual admission for acute pelvic pain and a large hematometra.
Findings:
- Post-operative VR reconstruction of pre-operative MRI revealed critical anatomical details, including ureters near the dilated horn, highlighting challenges for neovaginal reconstruction.
- The VR model underscored the value of prophylactic ureterolysis and demonstrated its potential for enhancing fertility counseling and surgical decision-making.
Implications:
- Post-operative VR reconstruction of pre-operative MRI demonstrated significant educational and planning value for complex Müllerian anomalies.
- Routine prospective VR adoption could optimize patient counseling, resident education, and surgical safety in managing these challenging conditions.
