Double uterus, or didelphic uterus, is a rare condition where a woman has two uteri. Symptoms include infertility, pain during intercourse, and abnormal menstrual bleeding. Treatment options include reconstructive surgery and elective C-sections during pregnancy. Diagnosis is made through imaging studies.
A double uterus, also known as a didelphic uterus, is a rare condition in which a woman has a duplication of the uterus. While the exact reason this congenital anomaly develops is unknown, it represents a lack of fusion of early embryonic structures. Symptoms may include infertility, pain during intercourse, and abnormal menstrual bleeding. Treatment options for the condition may include various reconstructive surgeries to create a more functional reproductive tract.
All women with double uterus have two uterine cavities. The extent of duplication seen in different women, however, can vary. Some women with this condition have two uterine cavities that join into a single cervix. Other women have two copies of the cervix, vagina, bladder and vulva along with two uteri.
While the exact cause is unknown, the developmental basis for having this condition is well understood. In normal female embryos, the reproductive tract consists of structures called Müllerian ducts, which arise from early precursors of the kidneys. Normally, these ducts grow and eventually merge to form a uterus connected to two fallopian tubes and two ovaries. Sometimes this process of joining the tubes is unsuccessful and without the fusion of the Müllerian ducts, two uteri are formed.
The symptoms caused by having a double uterus can vary depending on the patient. Some patients have obvious manifestations of the condition, as they have two vaginal cavities. Patients who have uterine duplication only may not be affected by manifestations of the condition until later in their lives. They might report symptoms such as pain during intercourse, abnormal menstrual cycles, infertility, or premature labor.
Diagnosis is often made with imaging studies. Radiographic tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI) tests can illustrate the presence of two uteri. A procedure called hysterosalpingography takes a picture of the female reproductive tract after a dye has been injected into the cervical canal. The advantage of this test is that it clearly outlines the walls of the uterus and can distinguish a double uterus from other congenital uterine abnormalities.
Depending on the symptoms and wishes of the patient, the treatment for having a double uterus varies. Often the condition limits a woman’s reproductive abilities, making sexual intercourse impossible or increasing the risks of a premature or complicated birth. Metroplasty, or plastic surgery of the uterus, reshapes the uterus to increase its reproductive capabilities and reduce symptoms associated with abnormal menstruation. Many women with the condition who become pregnant opt for an elective C-section to avoid having problems with the birthing process.
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