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We report a case of retained uterine fundus after vaginal hysterectomy that was subsequently removed at laparoscopy. The patient had undergone vaginal hysterectomy 8 years previously and came to our hospital with abdominal pain. Examination revealed a supravesical mass. Laparoscopy was performed and showed the uterine fundus with its cornual attachments. The mass was excised and sent for histopathologic analysis, which confirmed that it was uterine tissue. Retained uterine tissue or myoma tissue has been reported, usually after morcellation. However, to our knowledge, our case is only the second reported case of retained fundus after complete vaginal hysterectomy. Because of adhesions, it is possible that the uterus was not completely removed. In such cases, laparoscopic assistance is extremely useful.

A 38-year-old woman who had had pelvic heaviness for 1 month was admitted for laparoscopic myomectomy. She had 2 children, both delivered by cesarean section. Clinical examination revealed a pelvic mass measuring up to 24 weeks in size. Ultrasonography revealed a bulky uterus with a posterior wall myoma measuring 15!7 cm. Laparoscopy revealed a 15-cm left cornual pedunculated myoma that was vascular and had large feeder vessels arising from the omentum. The myoma occupied the entire pouch of Douglas. Another 2-cm posterior wall intramural myoma was also observed.