March 2025

OB-GYN

COMPLEX SURGERY BRINGS RELIEF FOR RARE UTERINE ANOMALY AND ENDOMETRIOSIS

From the time she was 14 or 15 years old, Sage D’Amato’s periods have always been extremely painful. Each month, the 37-year-old from Roberts, Ill., could barely get out of bed, and would try relieving the menstrual pain with heating pads, Tylenol and ibuprofen, but nothing helped.  ​
“It felt like I was giving birth every month,” said D’Amato. “In fact, when I gave birth to my two sons, I didn’t think the pain was that bad, because it just felt like another bad period.”
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Born with a rare uterine anomaly called unicornuate uterus with a rudimentary horn, which affects only about 0.03% of the population, D’Amato’s uterus primarily developed on the right side of her body, while the left side only partially developed. She also had a kidney anomaly called dysmorphic and rotated kidney in right lower abdomen with two collecting systems, meaning, two ureters (instead of one) were draining urine from one of her kidneys.    
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“I like to think of myself as a unicorn,” said D’Amato.
Magdy P. Milad performing operation at Prentice.
Magdy P. Milad, performing the operation at Northwestern Medicine Prentice Women's Hospital.
Five years ago, she started having even more pain on her lower left abdomen and decided to get it checked out. Her doctor at the time diagnosed her with an ovarian cyst and stage 3 endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus, causing severe pain and heavy periods. After having the ovary with the cyst removed, D’Amato then underwent endometriosis surgery, but the pain persisted and after going to a local emergency department, D’Amato asked for a referral to Northwestern Medicine in Chicago.

She first met with Micah W. Garb, MD, an obstetrician and gynecologist at Northwestern Medicine Catherine Gratz Griffin Lake Forest Hospital, who immediately recognized D’Amato needed a complex surgery to relieve the pain. D’Amato was referred to Magdy P. Milad, MD, chief of minimally invasive gynecologic surgery at Northwestern Medicine, who in collaboration with Ziho Lee, MD, a reconstructive urologist at Northwestern Medicine, performed the complicated surgery.
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“Sage’s unicornuate uterus was a risk factor for severe endometriosis, and hers was so severe that it was blocking her ureter, with urine backing up into her kidney. She had not responded to medications and had an endometriosis surgery back in 2023 at another health system, but that also didn’t help relieve the pain,” said Dr. Milad. “In January, Dr. Lee and I were able to operate together on the same day. I removed Sage’s uterus, then Dr. Lee took out the endometriosis blocking the ureter and re-implanted the ureter into the bladder. The surgery was a success and Sage did great postoperatively.”
Sage at work
Sage at work.
Two months later, D’Amato is back to enjoying life with her husband and kids. She’s also able to continue her work as a necropsy technician at the University of Illinois Urbana-Champaign, not having to worry about taking time off work due to extreme abdominal pains.  

“For the first time in over 20 years, I’m now living my life pain free,” said D’Amato. “Going to Northwestern Medicine was the best decision I’ve ever made, and I encourage all women who may be experiencing the same type of pain to advocate for themselves and seek a second opinion.”

March is Endometriosis Awareness Month, a time to raise awareness about the condition that affects approximately 6.5 million U.S. women who are of reproductive age. Endometriosis can cause scar tissue, chronic pain and heavy periods, and is a main cause of infertility in women. Treatment options include medicine, surgery or both.

For more information about endometriosis and treatment options at Northwestern Medicine, visit nm.org.

​This article was originally published in Northwestern Medicine Newsroom on March 24, 2025. 

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