6533b824fe1ef96bd127fe66

RESEARCH PRODUCT

The double uterus associated with an obstructed hemivagina: Clinical management

subject

description

Abstract The clinical management of It) patients, 9 with uterus didelphys and 1 with complete septate uterus associated with an obstructed hemivagina, is described. The diagnostic evaluation revealed a complete unilateral obstruction in four patients, and an anomalous communication between the two uterovaginal channels in six. In all such patients, the presence of regular menses is frequently misleading, perhaps resulting in unnecessary laparotomy and inadequate or extirpative surgery with negative reproductive consequences. However, diagnosis is simplified if the gynecologist is aware of the malformation. Recommended treatment consists of evacuation of the retained menstruum and excision of the vaginal wall. It is a simple, safe, and effective procedure but must be performed immediately following diagnosis in order to prevent or treat the related pelvic pathology (such as endometriosis or pelvic inflammatory disease). Drainage of the retained menstruum must be complete, otherwise infectious sequelae often occur. Fertility after therapy can well be preserved; however, reproductive success depends on the associated uterine malformation. Therefore, early establishment of the correct diagnosis followed by conservative treatment is mandatory in order to prevent pelvic pathology and to preserve reproductive potential.