Obstructed Mullerian Anomalies and Endometriosis in the Adolescent

Obstructive Mullerian anomalies can lead to retrograde menstruation and as such have been shown to cause endometriosis in the adolescent. Appropriate and early diagnosis and timely correction are paramount in preventing progression of severity and avoiding associated complications. Key elements for the diagnosis of obstructive Mullerian anomalies include a careful history, physical exam, laboratory studies, and imaging. Various classification systems have been proposed, which can aid in diagnostic description as well as approach to treatment. The presentation and management of the most well-known anomalies such as obstructed hemivagina ipsilateral renal anomaly syndrome (OHVIRA) and unicornuate uterus with obstructed uterine horn as well as more rare presentations such as cervical agenesis and uterine isthmus agenesis as well as other complex uterine anomalies are discussed.