Infantile Uterus (Hysterosalpingography)
An infantile uterus represents a developmental uterine abnormality characterized by incomplete uterine maturation, resulting in a small uterine cavity with a disproportionately long and narrow cervix. On hysterosalpingography, the uterine body is underdeveloped with a reduced cavity-to-cervix ratio, often resembling the prepubertal uterine configuration. This condition is commonly associated with primary infertility or amenorrhea (Fig. 1).
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| Fig-1 |
Findings: The uterine cavity is reduced in size with a tubular configuration. The fundus shows poor development, and the cervix appears disproportionately long. Fallopian tubes may be normal or hypoplastic.
Conclusion: Imaging findings are consistent with an infantile uterus.
Patient Symptoms
Patients commonly present with primary infertility, primary amenorrhea, delayed menarche, or menstrual irregularities. Some may have normal secondary sexual characteristics with isolated uterine hypoplasia.
Procedure (Hysterosalpingography)
The examination is performed in the early proliferative phase of the menstrual cycle. Under aseptic precautions, a cervical cannula or balloon catheter is introduced carefully due to cervical elongation. Contrast is injected slowly under fluoroscopic guidance to delineate uterine morphology and tubal patency.
Contrast Medium & Administration
A water-soluble iodinated contrast agent such as Iohexol or Iopamidol (300–350 mg iodine/mL) is used with the patient in the lithotomy position. Contrast volume is usually reduced, typically 6–8 mL, due to the small uterine cavity.
Instruments Used
- Sterile vaginal speculum (Cusco’s or Sims’)
- Uterine tenaculum (used gently if required)
- Leech–Wilkinson cannula
- Rubin cannula
- Balloon HSG catheter (small size)
- 10 mL sterile Luer-lock syringe
- Sterile connecting tubing
- Antiseptic solution
- Fluoroscopy unit
Safety Considerations
Care must be taken to avoid cervical trauma due to elongation and narrowing. Gentle, low-pressure injection is essential. Pregnancy and pelvic infection must be excluded prior to the procedure.
Related Conditions
Differential diagnoses include uterine hypoplasia, Turner syndrome, gonadal dysgenesis, müllerian agenesis (partial), and hormonal insufficiency. Correlation with clinical, hormonal, and sonographic findings is recommended.
Declaration
This case is presented for educational purposes only. Patient identity has been anonymized, and no personally identifiable information is disclosed.
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