A PRESENTING OF UTERUS DIDELPHYS: A CASE REPORT
DOI:
https://doi.org/10.61841/1hm40p67Keywords:
Uterus didelphys, embryogenic, ipsilateral fallopian tube, paramesonephricAbstract
This is a case of double uterus reported by a student in Chennai, India. The patient is an 18-year-old female from Malaysia of Indian descent who is of normal health condition. Uterus didelphys (sometimes also uterus didelphys) represents a uterine malformation where the uterus is present as a paired organ as the embryonic genetic fusion of the mullerian ducts failed to occur. As a result, there is a double uterus with two separate cervix, and often a double vagina as well. Each uterus has a single horn linked to the ipsilateral fallopian tube that faces its ovary. The uterus is formed during embryogenesis by the fusion of the two paramesonephric ducts (also called mullerian ducts). This process usually fuses the two mullerian ducts into a single uterine body but fails to take place in these affected women who maintain their double mullerian systems. A didelphic uterus will have a double cervix and is usually associated with a double vagina. Causes for the failure to fuse are not known. Associated defects may affect the vagina, the renal system, and less commonly, the skeleton. The condition is less common than these other uterine malformations: arcuate uterus, septate uterus, and bicornuate uterus. It has been estimated to occur in 1/3,000 women. The findings of this case study are that the double uterus condition is not abnormal, and if the patient suffers acute pain, then the patient will need to seek medical help and may, in extreme cases, need corrective surgery. This is evidence that the double uterus condition is not abnormal and that it can be managed if detected. In most of the cases, unless a pelvis scan is done, this will not be detected.
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References
1. Acién P. (1993). Reproductive performance of women with uterine malformations. Human reproduction 8(1): 122–126.
2. Asha B and Manila K (2008) An unusual presentation of uterus didelphys with obstructed hemivagina with ipsilateral renal agenesis. Fertility and sterility 90(3): 849.e9–10.
3. Burgis J. (2001). Obstructive Müllerian anomalies: case report, diagnosis, and management. American journal of obstetrics and gynecology 185(2): 338–344.
4. Buttram VC Jr. and Gibbons WE (1979) Müllerian anomalies: a proposed classification. (An analysis of 144 cases). Fertility and sterility 32(1): 40–46.
5. Chandler TM, Machan LS, Cooperberg PL, et al. (2009) Müllerian duct anomalies: from diagnosis to intervention. BJR supplement/BIR 82(984). The British Institute of Radiology: 1034–1042.
6. Fertility and sterility (1988) The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, müllerian anomalies, and intrauterine adhesions. 49(6): 944–955.
7. García González P, Meana Morís AR, GracíaChapullé A, et al. (2009) [The role of MRI in congenital cystic lesions in the pelvis: a case of uterus didelphys with double vagina, hematocolpos, and ipsilateral renal agenesis.]. Radiologia 51(2): 194–197.
8. Golan A, Langer R, Bukovsky I, et al. (1989) Congenital anomalies of the müllerian system. Fertility and sterility 51(5): 747–755.
9. Jindal G, Kachhawa S, Meena GL, et al. (2009) Uterus didelphys with unilateral obstructed hemivagina with hematometrocolpos and hematosalpinx with ipsilateral renal agenesis. Journal of human reproductive sciences 2(2): 87–89.
10. Karaca L, Pirimoglu B, Bayraktutan U, et al. (2015) Herlyn-Werner-Wunderlich syndrome: a very rare urogenital anomaly in a teenage girl. The Journal of Emergency Medicine 48(3): e73–5.
11. Kaufman Y. and Lam A. (2008). The Pelvic Uterus-like Mass—A Primary or Secondary Müllerian System Anomaly? Journal of minimally invasive gynecology 15(4): 494–497.
12. Kim TE, Lee GH, Choi YM, et al. (2007) Hysteroscopic resection of the vaginal septum in uterus didelphys with obstructed hemivagina: a case report. Journal of Korean Medical Science 22(4): 766–769.
13. Madureira AJ, Mariz CM, Bernardes JC, et al. (2006) Case 94: Uterus didelphys with obstructing hemivaginal septum and ipsilateral renal agenesis. Radiology 239(2). Radiological Society of North America: 602–606.
14. Martínez-Beltrán M, Giménez J, and Acién P (2012) Uterus Didelphys with Septate Cervix and Unilateral Endometrial Carcinoma: A Case Report. J Genit Syst Disor 1: 1. of 2. Citeseer: 2.
15. Olpin JD and Heilbrun M (2009) Imaging of Müllerian duct anomalies. Clinical obstetrics and gynecology 52(1): 40–56.
16. Raga F, Bonilla-Musoles F, Blanes J, et al. (1996) Congenital Müllerian anomalies: diagnostic accuracy of three-dimensional ultrasound. Fertility and sterility 65(3): 523–528.
17. Raga F, Bauset C, Remohi J, et al. (1997) Reproductive impact of congenital Müllerian anomalies. Human reproduction 12(10): 2277–2281.
18. Rock JA and Breech LL (1997) Surgery for anomalies of the mullerian ducts. TeLinde’s operative gynecology, 50th ed. New York: Lippincott-Raven: 687–729.
19. Takagi H, Matsunami K, Noda K, et al. (2003) Magnetic resonance imaging in the evaluation of double uterus and associated urinary tract anomalies: a report of five cases. Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology 23(5): 525–527.
20. Woelfer B, Salim R, Banerjee S, et al. (2001) Reproductive outcomes in women with congenital uterine anomalies detected by three-dimensional ultrasound screening. Obstetrics and gynecology 98(6): 1099–1103.
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