COMPLEX MÜLLERIAN MALFORMATION: A CASE REPORT OF EARLY SURGICAL INTERVENTION

Abstract

Müllerian malformations result from failures in the formation, fusion, or resorption of the Müllerian ducts, occurring between the 6th and 12th weeks of embryogenesis. The septate uterus is the most common anomaly, associated with dysmenorrhea, dyspareunia, and infertility. Early diagnosis is essential to prevent reproductive complications. This case report describes a 23-year-old patient with a complete uterine septum, true cervical duplication, and a longitudinal vaginal septum. The investigation included pelvic ultrasound and magnetic resonance imaging, confirming the complex malformation. Treatment involved hysteroscopic surgery with septoplasty and intrauterine device insertion to prevent synechiae. Postoperative follow-up revealed a residual septum, requiring a second septoplasty, which successfully restored the uterine cavity. The hysteroscopic approach proved effective, improving reproductive prognosis and symptom relief. This case highlights the importance of clinical suspicion, detailed diagnosis, and early intervention to enhance patients’ quality of life and pregnancy outcomes.