Congenital Uterine Anomalies with Obstructed Cervix,Hemivagina,or Both During Adolescence: Report of 22 Cases

ABSTRACT

The authors present their experience on the rare syndrome of a double uterus with obstruction. Between the years 1979 and 1992, the records of 22 patients with didelphys, bicornuate, or septate uterus with obstruction at the level of the cervix or the vagina were evaluated and carefully reviewed. For each patient, the clinical history features were examined, and the following procedures were used for further evaluation and diagnosis: gynecologic examination, pelvic sonography, CT or MRI scan, and laparoscopy. We also presented the surgical management and obstetric outcome. Pelvic pain was the most frequent symptom (54.5%). Accurate diagnosis was made by laparoscopy in 86.3% of the patients. In 18.2% of the patients, endometriosis was detected. Renal anomalies were seen in 50% of the patients. Excision of the vaginal septum and opening of the obstructed cervical os were the most common surgical procedures performed. The obstetric outcome in our series was 4 pregnancies (3 full term and 1 induced abortion). Significant postoperative complications were not seen. Most of the cases of didelphys, bicornuate, or septate uterus with obstruction are diagnosed during adolescence. Periodic pelvic pain and purulent discharge are common clinical symptoms. Diagnosis is also based on pelvic sonography, x-ray tests, and laparoscopy. Early management and prompt surgical intervention by skilled medical staff are recommended to prevent postoperative complications and improve the reproductive outcome. (J GYNECOL SURG 10:159,1994)