Uterus Didelphys With Bilateral Cervical Agenesis

Dwinda Rizary(1*), Dedy Hendry(2)

(1) Resident of Obstetrics and Gynecology, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
(2) Sub Division of Reproductive Endocrinology, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
(*) Corresponding Author

DOI: https://doi.org/10.25077/aoj.4.1.133-138.2020

Abstract


Background : The mullerian duct anomaly is a congenital abnormality of the female reproductive system caused by abnormal embryological development during pregnancy. If accompanied by cervical agenesis and infertility, intervention must be taken. Accurate diagnosis and proper treatment are very crucial to the future of reproduction and treatment of infertility in patients.

Objective: Reporting the handling of cases of uterine didelphys accompanied by bilateral cervical agenesis.

Method : Case report

Case: Reported cases of women aged 34 years with primary amenorrhea and 9 years primary infertility, not typical cyclic pain, normal secondary sex development and from gynecological examination obtained cervical agenesis. Transvaginal ultrasound examination found a mass with the appearance of adenomyosis. Laparoscopic performed show 2 masses, 1 mass resembling adenomyosis with a size of 9x6x5cm located lateral to the left pelvis and another mass in the form of a hypoplastic uterus with a size of 2x2x1cm visible 2 tubes with 2 ovaries within normal limits. Uterine mass resembling adenomyosis with a location far from the vagina making it difficult to do anastomoses while other uterus hypoplasia and non-functional. Hysterectomies were performed on the mass of adenomyosis with the results of PA was adenomyosis.

Conclusion: The uterus didelphys with bilateral cervical agenesis with 1 uterine adenomyosis and located in the pelvic lateral it was difficult to do uterovaginal anastomose so that hysterectomy was performed. Second uterine was hypoplasia and non-functional so that no action was taken. Need to think about "future fertility" in these patients and various options for having children.

Keywords: Primary Amenorrhea, Uterine Didelphys, Cervical Agenesis, Adenomyosis

Full Text:

PDF

References


Parikh, R., et al. (2013). "Mullerian anomalies: a cause of primary amenorrhea." International Journal of Reproduction, Contraception, Obstetrics and Gynecology: 393-397.

Boehnke, M., et al. (2016). "Uterine didelphys with concomitant renal anomalies in both mother and fetus." Journal of Pediatric Surgery Case Reports 14: 19-21.

Acien, P., et al. (2009). "Mullerian anomalies "without a classification": from the didelphys-unicollis uterus to the bicervical uterus with or without septate vagina." Fertil Steril 91(6): 2369-2375.

Helmy, Y. A. (2017). "Cervical agenesis with a functioning uterus: Successful surgical treatment by Foley’s catheter stent: A case report." Middle East Fertility Society Journal 22(1): 67-69.

Fritz M, Sperrof L. Clinical Gynecologi endocrinoloy and Infertility 8 th edition. Lippicort WiliiamWillims. USA; 2011.

Haydardedeoglu, B. and P. Caglar Aytac (2016). "A novel approach for congenital absence of the uterine cervix: Office hysteroscopic versapoint canalization using real-time trans-abdominal sonography guidance." Turk J Obstet Gynecol 13(1): 42-45.

Yoshiki, N., et al. (2008). "Unusual uterus didelphys presenting in the retroperitoneum." Fertil Steril 90(2): 427-428.

Lakshmy, S. and N. Rose (2016). "Congenital absence of uterine cervix." International Journal of Reproduction, Contraception, Obstetrics and Gynecology: 3634-3636.

Adair, L., 2nd, et al. (2011). "Uterus didelphys with unilateral distal vaginal agenesis and ipsilateral renal agenesis: common presentation of an unusual variation." J Radiol Case Rep 5(1): 1-8.

Arnold, K. C., et al. (2018). "Uterine Didelphys with Bilateral Cervical Agenesis in a 15-Year-Old Girl." J Pediatr Adolesc Gynecol 31(1): 64-66.

Mahmud, Nusrat, et al.(2014). “Successful Uterovaginal Anastomosis in An Unusual Presentation of Congenital Absence of Cervix.” J. South Asian Federation Of Menopause : 105-110


Refbacks

  • There are currently no refbacks.




Address for Correspondence:

Editorial Room Andalas Obstetrics and Gynecology Journal 3rd floor of KSM Obstetrics and Gynecology
RSUP Dr. M. Djamil Padang, Jl. Perintis Kemerdekaan Padang, Sumatara Barat, 25127