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?

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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

 

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 Dr. Sanjeev Mani, Bandra Holy Family Hospital, Mumbai