Reproductive surgery for müllerian anomalies: a review of progress in the last decade
New approaches for classification, diagnostics, and surgical management have been described and used in practice and research, but sufficient-quality evidence is required to resolve basic controversies and guide practice.
Volume 112, Issue 3, Pages 408–416
Artur Ludwin, M.D., Ph.D., Samantha M. Pfeifer, M.D.
Disorders of development, fusion, or resorption of paired müllerian ducts and urogenital sinus may cause various congenital malformations of the corpus uteri, cervix, vagina, and fallopian tubes. Classification systems have been developed to better characterize these anomalies, and each has advantages and disadvantages. Clinical correlation of classification of anomalies with pre- and postsurgical outcomes is needed to better direct treatment. Methods to evaluate these anomalies are primarily radiologic studies, with diagnostic surgery rarely used. Treatment of müllerian anomalies used to focus on relief of symptoms. Now, as diagnostic and surgical options have expanded, preservation or improvement of reproductive potential is a primary goal. As a consequence, controversies in surgical management have also developed. Future directions in this field include better-quality studies with the use of consistent diagnostic criteria to evaluate impacts of treatment on clinical outcomes.