Objective:

To investigate the clinical characteristics and individualized hysteroscopic conservative treatment strategies for a case of uterine didelphys with a single vagina complicated by bilateral adenomyosis, adenomyoma, and endometrial polyps.

Approach:

• Methods: A retrospective analysis was conducted on the clinical data of a reproductive-aged female patient admitted to Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine. The patient’s medical history, imaging features, surgical approach, and foll…

Key Findings:

• The patient presented with progressively worsening dysmenorrhea and menorrhagia.
• Imaging revealed uterine didelphys with bilateral diffuse adenomyosis and adenomyoma, accompanied by endometrial polyps.
• Hysteroscopic polypectomy was performed, followed by the placement of a levonorgestrel-releasing intrauterine system in the right cavity and a GyneFix® IUD in the left cavity.
• At the 12-month follow-up, the patient's dysmenorrhea VAS score decreased from 9 to 2, and the PBAC score decreased from 280 to 35, with no device expulsion or lesion recurrence.

Interpretation:

Hysteroscopic individualized selection and suture fixation of intrauterine devices can serve as an effective uterus-preserving treatment option for patients with complex uterine anomalies complicated by adenomyosis.

Limitations:

• The study is based on a single case, limiting generalizability.
• Long-term outcomes beyond 12 months are not reported.

Conclusion:

The case highlights the potential for individualized hysteroscopic approaches in managing complex Müllerian anomalies.