{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T06:27:08Z","timestamp":1786602428889,"version":"build-2736575974"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Persistent urogenital sinus (PUGS) is a rare congenital malformation characterized by the confluence of the urethra and vagina into a single distal channel. It may be associated with other congenital anomalies, including M\u00fcllerian malformations. Although typically diagnosed in childhood, delayed diagnosis may occur, particularly in patients with mild or nonspecific symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a 39-year-old nulliparous woman referred for suspected complex genital malformation, presenting with chronic pelvic pain, dyspareunia, and recurrent urogenital infections. A one-stop diagnostic and operative approach, combining transvaginal ultrasound and hysteroscopy, identified PUGS associated with a complete bicorporeal uterus, double cervix, and partial longitudinal non-obstructing vaginal septum (U3bC2V1 according to the ESHRE\/ESGE classification). A 15-Fr bipolar mini-resectoscope was used for incision of the vaginal septum and removal of a concomitant FIGO type 0 fibroid in the right hemiuterus. The procedure was completed without complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The integration of expert ultrasound and endoscopic evaluation enabled accurate anatomical characterization and guided tailored surgical management. The use of a 15-Fr bipolar mini-resectoscope allowed effective treatment in a complex anatomical setting, avoiding cervical dilation while providing adequate maneuverability and simultaneous cutting and coagulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A one-stop approach in a specialized center may improve diagnostic accuracy and support safe, individualized minimally invasive management of complex congenital urogenital anomalies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1890509","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:32:36Z","timestamp":1786599156000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Persistent urogenital sinus (PUGS) associated with complete bicorporeal uterus, double cervix and partial longitudinal non-obstructing vaginal septum: a one-stop diagnostic and operative hysteroscopic approach"],"prefix":"10.3389","volume":"13","author":[{"given":"Emma","family":"Bonetti Palermo","sequence":"first","affiliation":[{"name":"S.C. Ostetricia e Ginecologia, ASST Spedali Civili di Brescia, Dipartimento Area della Donna e Materno Infantile","place":["Brescia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Zorzi","sequence":"additional","affiliation":[{"name":"Ovarian Cancer Center, Candiolo Cancer Institute, FPO-IRCCS","place":["Torino, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pozzati","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Ferrari","sequence":"additional","affiliation":[{"name":"S.C. Ostetricia e Ginecologia, ASST Spedali Civili di Brescia, Dipartimento Area della Donna e Materno Infantile","place":["Brescia, Italy"]},{"name":"Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili","place":["Brescia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Odicino","sequence":"additional","affiliation":[{"name":"S.C. Ostetricia e Ginecologia, ASST Spedali Civili di Brescia, Dipartimento Area della Donna e Materno Infantile","place":["Brescia, Italy"]},{"name":"Department of Clinical and Experimental Sciences, University of Brescia, ASST Spedali Civili","place":["Brescia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia Carla","family":"Testa","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS","place":["Rome, Italy"]},{"name":"G-AURIG\u2013Gemelli Advanced Ultrasound Research and Innovation Group, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS","place":["Rome, Italy"]},{"name":"Gemelli Women\u2019s Health Center for Digital and Personalized Medicine, Dipartimento Scienze Della Vita e Sanit\u00e0 Pubblica, Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Catena","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze Della Salute Della Donna e del Bambino, Fondazione Policlinico Universitario A. Gemelli, IRCCS","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"124","DOI":"10.4103\/aja.aja_72_19","article-title":"The embryology of persistent cloaca and urogenital sinus malformations","volume":"22","author":"Thomas","year":"2020","journal-title":"Asian J Androl"},{"key":"B2","doi-asserted-by":"publisher","first-page":"78","DOI":"10.5582\/irdr.2023.01027","article-title":"Urogenital sinus malformation: from development to management","volume":"12","author":"Ding","year":"2023","journal-title":"Intract Rare Dis Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3390\/medicina61020191","article-title":"Management of high urogenital sinus in adults: a scoping review","volume":"61","author":"Hammad","year":"2025","journal-title":"Medicina (Kaunas)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1105551","DOI":"10.3389\/fsurg.2023.1105551","article-title":"Ultrasound-guided endoscopy to improve accuracy of persistent urogenital sinus (PUGS) diagnosis in adult patient: a case report","volume":"10","author":"Mirandola","year":"2023","journal-title":"Front Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1093\/humupd\/dmr028","article-title":"The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review","volume":"17","author":"Chan","year":"2011","journal-title":"Hum Reprod Update"},{"key":"B6","doi-asserted-by":"publisher","first-page":"287","DOI":"10.52054\/FVVO.13.4.037","article-title":"International consensus statement for recommended terminology describing hysteroscopic procedures","volume":"13","author":"Carugno","year":"2021","journal-title":"Facts Views Vis Obgyn"},{"key":"B7","first-page":"115","article-title":"Outpatient hysteroscopy","volume":"10","author":"Campo","year":"2018","journal-title":"Facts Views Vis Obgyn"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/humrep\/det098","article-title":"The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies","volume":"28","author":"Grimbizis","year":"2013","journal-title":"Hum Reprod"},{"key":"B9","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.tjog.2013.04.034","article-title":"Differentiating between a double cervix or cervical duplication and a complete septate uterus with longitudinal vaginal septum","volume":"52","author":"Ludwin","year":"2013","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1002\/ijgo.15393","article-title":"Efficacy, safety, and feasibility of the treatment of intrauterine pathologies with the mini-resectoscope: a systematic review","volume":"166","author":"Etrusco","year":"2024","journal-title":"Int J Gynaecol Obstet"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ijgo.71015","article-title":"Standardized hysteroscopic management of complete septate uterus with duplicated cervices and longitudinal vaginal septum: a single-center experience","author":"Catena","year":"2026","journal-title":"Int J Gynaecol Obstet"},{"key":"B12","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1055\/s-0035-1565996","article-title":"Persistent urogenital Sinus: diagnostic imaging for clinical management. What does the radiologist need to know?","volume":"33","author":"Valentini","year":"2016","journal-title":"Am J Perinatol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1890509\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T05:32:38Z","timestamp":1786599158000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1890509\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":12,"alternative-id":["10.3389\/fsurg.2026.1890509"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1890509","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1890509"}}