Double Uterus

A person with uterine didelphys, an uncommon disorder, will grow two uteruses. Another name for it is a double uterus. You are born with a congenital anomaly called a double uterus. The spaces between your two uterine chambers are smaller than those of a typical uterus. Each uterus has its own ovary and fallopian tube.

Two ducts are where a uterus begins. These ducts come together to form the uterus during the development of a fetus. Your uterus is a single hollow organ that resembles an emaciated pear. The two ducts do not converge if you have uterine didelphys. Instead, each duct develops a separate uterus, giving you two. Two cervixes and two vaginal canals may also be present in some patients with a double uterus. If you have uterine didelphys, your uteruses seem more like bananas than pear shapes.

Just 0.3% of people have uterus didelphys, an uncommon condition. It is one of the rarest uterine abnormalities.

A bicorn uterus has a heart-like shape. You still have one uterus, but it is now heart-shaped rather than pear-shaped. There are two distinct uteruses if you have uterus didelphys. Contrary to uterine didelphys, a bicornuate uterus is more typical. A bicornuate uterus is congenital, meaning it is something you are born with, similar to uterus didelphys. Both disorders have the potential to complicate pregnancy.

Your pregnancy may be impacted by uterus didelphys. While they can still have good pregnancies, women with a double uterus are more likely to have a loss and premature delivery.

Double Uterus: Causes

When two ducts (the Mullerian ducts) fail to correctly join during development, the result is uterus didelphys. Normally, these tubes combine to form a single uterus. The ducts did not unite if you had two uteri; instead, each duct developed into a separate uterus.

Moreover, some persons have two cervixes and vaginas. Healthcare professionals don't fully understand why Mullerian ducts don't merge in certain patients.

Double Uterus: Symptoms

Due to the lack of symptoms, the majority of people are unaware they have uterine didelphys. Instead, it is found while doing a normal pelvic check or while looking at cases of severe menstrual discomfort or recurrent miscarriages.

You may have any of the following signs of uterine didelphys −

• Suffering when having sex.

• Severe cramps before and during your menstruation.

• Bleeding a much throughout your menstruation.

• Using a tampon while leaking blood (a tampon is only in one uterus and not the other).

• A lot of miscarriages.

• Pregnancy labor.

Uterus didelphys may have an impact on your menstruation in one or more of the following ways −

• Menstrual bleeding that is very thick or heavy.

• Difficult times.

• Pelvic pressure and cramps.

• A challenge in utilizing tampons.

Many double-uterine patients experience typical sex lives, pregnancies, and births. Yet occasionally, a double uterus and other uterine development anomalies are linked to −

• Infertility

• Miscarriage

• Birth prematurely

• Kidney issues

Double Uterus: Risk Factors

Why some fetuses have a second uterus while others do not is unknown to doctors. Because this uncommon illness occasionally runs in families, a genetic component may be a contributing factor.

Double Uterus: Diagnosis

The diagnosis of the double uterus is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

When your doctor feels an unusually shaped uterus or notices a double cervix during a regular pelvic exam, they may conclude that you have a double uterus. Your doctor could suggest one or more of the following tests to solidify the diagnosis −

• Ultrasound. High-frequency sound waves are employed in this examination to produce pictures of the interior of your body. A tool known as a transducer is either placed against your abdomen skin or put into your vagina to acquire the photos (transvaginal ultrasound). For the best view, both forms of ultrasonography may be used. If one is available, a 3-D ultrasound may be used.

• Sonohysterogram. Once the fluid is injected through a tube into your uterus via your vagina and cervix, a sonohysterogram, an ultrasound study, is performed. This enables your doctor to check for uterine shape issues.

• Imaging with magnetic resonance (MRI). The MRI scanner resembles a tube with open ends. On a portable table that slides into the tunnel's entrance, you lie down. Cross-sectional pictures of the interior of your body are produced using a magnetic field and radio waves during this painless process.

• Hysterosalpingography. A unique dye is put into your uterus during hysterosalpingography through your cervix. While the dye passes through your reproductive organs, X-rays are obtained to evaluate the shape and size of your uterus and if your fallopian tubes are open.

Double Uterus: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Treatment is seldom necessary if you have a double uterus but don't have any symptoms or indicators. Although surgery may help you retain a pregnancy if you have a partial uterine division and no other medical cause for a previous miscarriage, it is uncommon to have surgery to unify a double uterus.

You can be a candidate for surgery to remove the tissue wall dividing the two vaginas if you also have a second uterus and a second vagina. This could ease labor a little bit.

The research on women with didelphys uteri who had metroplasty is quite a find, and surgical repair of a didelphys uterus (metroplasty) is not often needed. Having said that, metroplasty would only be taken into consideration on a case-by-case basis after all other options for enhancing reproductive function have been explored. Women with septate or bicornuate uteri who have a history of infertility and frequent abortions have improved reproductive and gestational outcomes following metroplasty, according to observational studies.

Double Uterus: Prevention

Uterus didelphys is congenital, meaning it developed during fetal development, hence it cannot be prevented. Healthcare professionals are unsure of the cause of uterine anomalies or if they are genetic.

Conclusion

In contrast to other more frequent anomalies, the didelphys uterus is a highly uncommon Mullerian duct abnormality with variable reproductive and gestational consequences.

Conceivability is still a subject that is up for debate. Excision of the vaginal septum may be necessary if the woman is symptomatic, but surgical repair (metroplasty) is typically not advised due to a lack of evidence. Unless the vaginal septum is thick and inelastic, increasing the risk for vaginal dystocia, didelphys uterus is not a reason for cesarean delivery. There is no evidence that the didelphys uterus causes cervical incompetence. Last but not least, to rule out Herlyn-Werner-Wunderlich (HWW) syndrome, renal abnormalities should be examined when a didelphys uterus is identified.

Generally, there is not a lot of material currently accessible on the didelphys uterus. So that doctors may properly counsel and care for their patients, further research is required to better understand the reproductive and gestational outcomes.