Pathological full duplication of the uterus and cervix is a process in the female genital organs, usually occurring during childbirth. The appearance of the disease indicates the abnormal development of two uteruses at once, as well as two vaginas that have branches.
General characteristics of the state
The uterus tends to double as the fetus ripens. This is facilitated by a negative external influence, which can be found in the sections of the article. Müllerian tubes in this state of the reproductive system of a woman do not merge. According to doctors, such a violation can be partial or complete.
The most obvious manifestation of pathology is called the absolute doubling of not only the woman's uterus, but also her vagina. The organ is isolated, and two cervixes, ovaries, two vaginas, and two tubes can come out of it.
In some cases, the organ can be separated from the vagina by the bladder, rectum, or simply come into contact with them. Depending on the existing features of the female genital organs, both halves can develop as full-fledged organs. But in some cases, with fullduplication of the uterus and vagina, one part may develop worse than the other.
The disease can occur simultaneously with other disorders in the genitourinary system of a woman. The most correct indication for performing an operation in case of detection of this pathological condition is the threat of miscarriage, as well as the impending conception of a child for a long time.
Types of pathology
Doctors have identified 2 types of this pathology:
- A pathology with an incompletely aplastic vagina, causing impaired outflow of blood from the reproductive organs (incomplete duplication of the uterus).
- Pathology without disturbed outflow of blood during the menstrual cycle.
Classification of anomaly forms
When a similar pathology is detected, the cervix and vagina will be common, but the following types of anomalies are noted:
- An organ with an appendage-horn that differs in structure. A hollow appendage organ emerges from the uterus, which can fulfill its role, regardless of the reproductive organ.
- Bicorne with normal vagina and cervix, but with marked doubling.
- The saddle type organ represents the first stage of the appearance of the previous type of anomaly - the bicornuate uterus. With such a pathology, the bottom of the organ is usually deformed.
- The intrauterine septum divides the organ into 2 parts with different depths.
Causes of pathology
Usually, disorders of this type occur during embryogenesis, which may be due to externalinfluence of pathogenic, genetic and endocrine factors. With the normal development of the child, the distal ducts are combined, the VG-parts and MT-structures are formed. The SH part develops due to the convergence of the caudal segment of the Muller ducts, the cloaca, and the urogenital sinus.
With the observed doubling of the uterus in the above area, the connection during embryogenesis does not occur, causing certain anomalies in the development of the child. The occurrence is usually accompanied by disorders of the urinary system.
Unfavorable changes in the full development of the embryo can occur for a variety of reasons:
- malnutrition during pregnancy, lack of vitamins, from which the embryo also suffers;
- infectious diseases that a woman suffered in the first trimester of pregnancy, during the formation of the embryo;
- taking medications that negatively affect the fetus;
- endocrine disorders;
- severe toxicosis at the beginning of pregnancy;
- constant stress;
- intoxication due to the use of harmful substances, tobacco and alcohol during pregnancy.
Also, the embryo may develop incorrectly due to adverse factors of heredity, so it is worth paying special attention to patients who have previously had such anomalies in the family. The pathological development of the reproductive organs is often noted with concomitant insufficient functioning of the kidneys.
Symptoms of pathology
For quite a long time, doubling of the uterus may not manifest itself, and is mainly detected during a routine examination by a gynecologist. You can diagnose when performing an ultrasound scan, as well as during surgery.
Girls with partial SH aplasia experience blood pooling in the uterus during menstruation. So, some time after menstruation, girls may experience rather sharp pains in the lower abdomen, which cannot be eliminated with antispasmodic drugs.
With the formation of fistulous openings, mucopurulent and bloody secretions can penetrate into the body. In the case of a bicornuate formation that has a closed working horn, after some time in adolescence, complaints of pain in the lower abdomen may appear. All other known varieties of uterine duplication have no particular symptoms.
Such a latent course of the disease usually forces women to consult a gynecologist for advice, perform an ultrasound diagnostician, and also undergo an annual examination by a doctor.
Algodysmenorrhea
This condition usually occurs when the ovaries fail to function, and also when the uterus doubles. Moreover, it is worth noting that the development of two reproductive organs in a woman does not affect her ability to bear a fetus if they are full.
But sometimes there can be a complication, for example, premature contractions or termination of pregnancy. Such a pathological condition of the uterus in some cases indicates the development of metrorrhagia,insufficient labor activity, complications during childbirth, as well as other equally serious complications during pregnancy.
The fetus, fixed in a certain part of the uterus, can provoke the appearance of a decidua in its neighboring part. Throughout the recovery period after childbirth, the membrane should be completely shed.
If there is a severe pregnancy, the doctor may advise to terminate it, which involves curettage of the organ cavity.
If the baby develops in an underdeveloped part of a bicornuate uterus, the patient may be diagnosed with an ectopic pregnancy. Undoubtedly, such a condition can pose a certain danger to the woman's body, since bleeding can occur as a result of a rupture of the horn.
Diagnosis of pathology
As noted above, a woman may be unaware of the presence of a doubling of the uterus for quite some time. A similar pathology manifests itself at the beginning of sexual activity, or when there are problems with pregnancy in general. Gynecological examination in women usually does not reveal external changes in the genital organs.
Diagnosis of pathology consists of the following comprehensive measures:
- Collecting and studying an anamnesis to compile a complete clinical picture of the disease.
- Careful study of the causes that provoke the development of the anomaly.
- Performing a gynecological examination that helps to identify the manifestations of pathology, pushing a woman to better diagnostics for an accurate diagnosis.
- Hysteroscopy.
- Vaginoscopy.
- Study of a woman's genitals through the use of MRI and ultrasound. These are the most commonly used methods that allow you to identify pathology in any form. Using ultrasound and MRI, it is possible to identify renal agenesis and determine the size and structure of the uterus. MRI makes it possible to determine the most optimal method of the applied operation.
- Additional examination of the kidneys to avoid the development of their pathologies.
- Colposcopy to detect abnormalities in the cervix. If its doubling is detected, this examination method allows you to identify the location and size of the reproductive organs.
When to see a doctor
Complete doubling of the uterus is mainly detected during a routine gynecological examination. It is noteworthy that about 40% of the total number of patients learn about the presence of pathology due to incorrectly prescribed treatment or due to incorrect actions of doctors: unintended removal of appendages, bougienage of the cervical canal, and also appendectomy.
It is often difficult to pinpoint the exact cause of a double uterus, especially in teenage girls. Therefore, when a pathology and existing congenital anomalies of the reproductive system are detected, gynecologists strongly recommend performing a complete gynecological examination in order to be able to determine the malformations of other organs. In most cases, the MRI method is used for this, which allows you to get the most complete information about the condition of all femalegenitals.
Treatment of pathology
When diagnosing doubling of the uterus, irregular menstruation, partial aplasia of the vagina, a surgical operation should be performed. The surgeon performs an incision in the walls of the vagina, creating a kind of thread between the uterine cavities, providing an outflow of hematocolpos. The patient is scheduled for vaginal sanitation.
Laparoscopic examination is performed to clarify the location of organs. It is very important to remove the existing accumulations of blood in the uterus and its tubes, to view the entire peritoneum.
Extirpation of the rudimentary uterus helps to determine the additional formation of a closed horn by performing laparoscopy. The procedure allows you to save the fallopian tube, as well as the ovary.
When an intrauterine septum is formed, as well as in case of problematic functioning of the reproductive system, the patient may be prescribed metroroplasty. If a doubling of the uterus with bilateral aplasia is detected, abdominal colpopoiesis and colpoelongation are used.
Surgical treatment
Surgical methods for doubling the body of the uterus are mainly used to detect impaired blood outflow during menstruation. With a closed adnexal horn, a woman may be shown to remove it. Uterine septa usually do not require surgical treatment, but still, so that a woman can give birth to a child in the future, this method can be used.
Examination by specialists
If, in addition to the disturbed structure of the genital organs, a woman was found to have abnormal functioningbladder and kidneys, then additional therapy should be prescribed by a nephrologist, as well as a urologist. For each woman, the doctor must choose his own, special method of treating doubling, since the reproductive organs of different patients have a distinctive anatomical structure.
As it became clear, complete doubling of the uterus and pregnancy are compatible things. The main thing is to detect the problem in a timely manner, as well as follow all the recommendations and complete the full course of treatment.
