Vaginal Hysterectomy of the Didelphic Uterus.

Hysterectomy of the didelphic uterus is extensively documented utilizing the laparoscopic and abdominal surgical approach with very few cases documenting the vaginal approach. This report will discuss the surgical modifications to the vaginal hysterectomy (VH) technique successfully employed in a case of a didelphic uterus. These techniques include staged transection of the uterosacral ligaments for the difficult posterior colpotomy, morcellation for the enlarged size of the uterus, and inversion of the uterus for delivery through the vaginal canal. This case displays the feasibility of the vaginal route for the didelphic uterus and augments the American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 701 by expanding the patient pathology that qualifies for benign indications for hysterectomy through the most minimally invasive route.

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Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.