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

Affiliations
  • 1Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ttadak@hanmail.net

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

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

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

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

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

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


Reference

1. Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001. 7:161–174.
2. Golan A, Langer R, Bukovsky I, Caspi E. Congenital anomalies of the mullerian system. Fertil Steril. 1989. 51:747–755.
3. Purslow CE. A case of unilateral hematocolpos, hematometra and hematosalpinx. J Obstet Gynaecol Br Emp. 1922. 29:643.
4. Youn MH, Kwak MJ, Kim JU, Jang MG, Joo SH, Jin K. A case of the uterus didelphys with unilateral obstructed hemivagina. Korean J Obstet Gynecol. 2004. 47:1620–1624.
5. Stassart JP, Nagel TC, Prem KA, Phipps WR. Uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis: the University of Minnesota experience. Fertil Steril. 1992. 57:756–761.
6. Lee BH, Kim JW, Oh SI, Kim MH, Park NH, Lee JY, et al. 3 cases of uterus didelphys with an obstructed hemivagina and ipsilateral renal agenesis. Korean J Obstet Gynecol. 1997. 40:1489–1495.
7. Pinsonneault O, Goldstein DP. Obstructing malformations of the uterus and vagina. Fertil Steril. 1985. 44:241–247.
8. Park JS, Ahn ST, Kim MR, Hwang KJ. Diagnosis and treatment of uterine didelphys with obstructed hemivagina and ipsilateral renal agenesis. Korean J Obstet Gynecol. 2009. 52:781–785.
9. Raga F, Bonilla-Musoles F, Blanes J, Osborne NG. Congenital Mullerian anomalies: diagnostic accuracy of three-dimensional ultrasound. Fertil Steril. 1996. 65:523–528.
10. Choi EJ, Choi YS, Kim HM, Hahn WS, Park EJ, Park WI. Three-dimensional ultrasonographic diagnosis of uterus didelphys, obstructive hemivagina and ipsilateral renal agenesis: Herlyn-Werner-Wunderlich syndrome. Korean J Obstet Gynecol. 2009. 52:1180–1184.
11. Sardanelli F, Renzetti P, Oddone M, Toma P. Uterus didelphys with blind hemivagina and ipsilateral renal agenesis: MR findings before and after vaginal septum resection. Eur J Radiol. 1995. 19:164–170.
12. Cicinelli E, Romano F, Didonna T, Schonauer LM, Galantino P, Di Naro E. Resectoscopic treatment of uterus didelphys with unilateral imperforate vagina complicated by hematocolpos and hematometra: case report. Fertil Steril. 1999. 72:553–555.
13. Gilliland B, Dyck F. Uterus didelphys associated with unilateral imperforate vagina. Obstet Gynecol. 1976. 48:5S–8S.
14. Ryu AL, Kim YS, Mun ST, Jeon S, Choi SD, Sunwoo JG, et al. Acute renal failure associated with ureteral stone of the unilateral kidney and uterus didelphys with hemivaginal obstruction. Korean J Obstet Gynecol. 2009. 52:261–265.
15. Kim YI, Kim JH, Shin OC, Cho JC, Kang CS, Ahn KB, et al. Uterus didelphys with an obstructed hemivagina and ipsilateral renal agenesis. Korean J Obstet Gynecol. 1998. 41:1202–1205.
Full Text Links
  • KJOG
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr