Uterine Didelphys

What Is Uterine Didelphys?

Uterine Didelphys is a disorder present before birth in which a female develops two uteruses instead of one. In a typically developing female fetus, two ducts (channels) known as mullerian ducts, (the early structure within an embryo that develop into a female's reproductive organs) which began as two small tubes, join to create one larger organ, the uterus. If the tubes do not join completely, each tube may turn into a separate uterus. The result can be two uteruses.

A patient with two uteruses may also have two cervixes (openings to the vagina) and two vaginas. The vagina is a closed canal that extends from the outside of the female genital area up to the cervix, the neck of the uterus.

What Are the Symptoms of Uterine Didelphys?

A patient with uterine didelphys may not know it. But treatment could be needed if symptoms occur such as unusual pressure or cramping pain before or during a menstrual period, an abnormally high amount of bleeding during a menstrual period, repeated miscarriages or preterm labor.

How Is Uterine Didelphys Diagnosed?

A pelvic exam could reveal the presence of two uteruses. Once that exam is done, a physician may decide to do an ultrasound, an MRI (Magnetic resonance imaging), a Sonohysterogram (an ultrasound scan, that is done after fluid is injected through a tube into the uterus by way of the vagina and cervix) or Hysterosalpingography (an exam in which dye is injected into the uterus through the cervix. As the dye moves through the reproductive organs, X-rays are taken to determine the shape and size of the uterus.) In females, the evaluation of those anomalies is an important part of the assessment of a child with anorectal malformations.

Associated Disorders

Patients with Uterine Didelphys may also have trouble with:

  • An anorectal malformation (imperforate anus)
  • Infertility 
  • Kidney abnormalities
  • Endometriosis- a condition that often causes painful menstrual periods. The disorder occurs when tissue that normally lines the inside of a woman's uterus, the endometrium, grows outside of the uterus. As a result, the endometrial tissue continues to act as it normally would; it thickens, breaks down and bleeds with each menstrual cycle. Because this tissue that has grown in the wrong place has no way to exit the body, it becomes trapped. When endometriosis involves the ovaries, cysts (growths) may form. 

What Is the Treatment for Uterine Didelphys?

It is rare for a patient with a double uterus to go through surgery to unite the uterus. But surgery may help a patient sustain a pregnancy if she has a partial division within her uterus and no other medical explanation for a previous pregnancy loss.