OBGY Radiology
Case 9 :
31-year-old infertile female with 2 months amenorrhoea (USG)
A 55-year-old female, with history of pelvic mass, presents with loss of weight and abdominal distension. What is the diagnosis?

Click here for bigger picture

Click here for bigger picture

Click here for bigger picture
Fig 1  Fig 2  Fig 3 


__________SCROLL FOR ANSWER__________
Imaging Findings
USG findings reveal a bicornuate uterus with polycystic ovaries. A large echo-poor mass lesion is seen in the vagina (atretic vaginal canal with hematocolpos)

Diagnosis
Uterine didelphys with hematocolpos in an atretic (R) vaginal canal.

Discussion
A uterus didelphys is a double uterus sometimes associated with a double cervix. In approximately 75% of cases, a thin wall separates the vagina into two parts.  

Most women with a uterus didelphys experience no symptoms though they may experience dyspareunia as a result of the vaginal wall. The reproductive outcome of women with the condition is better than with other types of uterine anomalies, because of a better blood supply. The likelihood of having a successful pregnancy with a uterus didelphys is approximately 60%. However, women with the condition are at high risk of premature labor and spontaneous abortion due to an incompetent cervix. Surgical correction of a uterus didelphys is rarely indicated, but pregnant women should be closely monitored for proper cervical function.

The first Link (1) gives a diagrammatic description of types of uterine anomalies.

Netlinks

 

1          2            3         

 

 Dr. Sanjeev Mani, Bandra Holy Family Hospital, Mumbai