Korean J Obstet Gynecol.  2011 May;54(5):273-277. 10.5468/KJOG.2011.54.5.273.

A case of the uterus didelphys with unilateral obstructed hemivagina and ipsilateral renal agenesis

• Jeon EJ
• You RM
• Kwon SK
• Yoon JW
• Kang HJ
• Kim SH
• Chae HD
• Kim CH
• Kang BM

• KMID: 2078025
• DOI: http://doi.org/10.5468/KJOG.2011.54.5.273

Abstract

Uterus didelphys with unilateral obstructed hemivagina, and ipsilateral renal agenesis is a rare congenital anomaly due to Mullerian duct malformation. The most common clinical manifestation is dysmenorrhea, pelvic pain, vaginal or pelvic mass after menarche. Early diagnosis is important, to preserve fertility, to prevent adhesion due to retrograde menstruation, hematometra, hematosalpinx and endometriosis which lead to distorted pelvic anatomy. These anomalies could be diagnosed with ultrasonography and magnetic resonance imaging. Resection or incision of vaginal septum is adequate treatments to relieve symptoms and reserve fertility. We report a case of uterus didelphys with unilateral obstructed hemivagina and ipsilateral renal agenesis with a brief review of the literature.

Keyword

Uterus didelphys; Obstructed hemivagina; Ipsilateral renal agenesis

MeSH Terms

Congenital Abnormalities
Dysmenorrhea
Early Diagnosis
Endometriosis
Female
Fertility
Hematometra
Kidney
Kidney Diseases
Magnetic Resonance Imaging
Menarche
Menstruation Disturbances
Pelvic Pain
Uterus
Congenital Abnormalities
Kidney
Kidney Diseases

Figure

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  Fig. 1 Transvaginal ultrasonography shows a large paravaginal cystic mass, 4.5×3.5 cm with turbid content.

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  Fig. 2 (A) MRI shows uterus didelphys. (B) MRI shows paravaginal cystic mass. (C) MRI shows absence of Lt kidney.

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  Fig. 3 Laparoscopic finding shows uterus didelphys and normal finding of both ovaries and salpinges.

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  Fig. 4 Diagram of resection of vaginal septum providing drainage of the retained pus.

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  Fig. 5 After opertation, the paravaginal mass was disappeared in MRI.

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