Uterus Didelphys

Uterus didelphys is a rare congenital uterine anomaly where a female is born with two separate uteri, each connected to a cervix and possibly a double vagina. This condition occurs during fetal development when the Müllerian ducts fail to fuse properly.

Cause

The exact cause of uterus didelphys is not well understood, but it is believed to be related to genetic mutations or environmental factors that affect the development of the reproductive system during embryogenesis. The condition is usually diagnosed incidentally during pelvic examination, imaging studies, or surgery for other indications.

Symptoms

Women with uterus didelphys may experience a range of symptoms, including:

• Pelvic pain or cramping
• Abnormal vaginal bleeding or menstrual irregularities
• Infertility or recurrent miscarriages
• Pregnancy complications, such as preterm labor or fetal growth restriction
• Urinary tract infections or other urinary symptoms due to the abnormal anatomy

Diagnosis

The diagnosis of uterus didelphys is typically made using a combination of imaging studies and physical examination. The following tests may be used:

• Pelvic ultrasound: to visualize the uterine anatomy
• Magnetic resonance imaging (MRI): to provide detailed images of the reproductive organs
• Computed tomography (CT) scan: to evaluate the pelvic anatomy and rule out other conditions
• Hysterosalpingography: to assess the shape and function of the uteri and fallopian tubes
• Pelvic exam: to assess the vaginal and cervical anatomy

Treatment

The treatment for uterus didelphys depends on the individual's symptoms, fertility goals, and overall health. The following options may be considered:

• No treatment: if the condition is asymptomatic and does not affect fertility or menstrual function
• Surgical correction: to remove any obstructive tissue, repair vaginal septa, or unify the uteri
• Hormonal therapy: to regulate menstrual cycles and reduce symptoms
• Assisted reproductive technology (ART): to improve fertility outcomes in women with uterus didelphys

Complications

Women with uterus didelphys are at increased risk for several complications, including:

• Infertility or recurrent miscarriages
• Pregnancy complications, such as preterm labor or fetal growth restriction
• Urinary tract infections or other urinary symptoms due to the abnormal anatomy
• Endometriosis or other gynecologic conditions

Prognosis

The prognosis for women with uterus didelphys varies depending on the severity of the condition, fertility goals, and overall health. With proper diagnosis and treatment, many women with uterus didelphys can experience significant improvement in symptoms and quality of life.