Double uterus
Overview
A double uterus is a rare congenital
abnormality. In a female fetus, the uterus starts out as two small tubes. As
the fetus develops, the tubes normally join to create one larger, hollow organ
— the uterus.
Sometimes, however, the tubes don't join
completely. Instead, each one develops into a separate structure. A double
uterus may have one opening (cervix) into one vagina, or each uterine cavity
may have a cervix. In many cases, a thin wall of tissue runs down the length of
the vagina, dividing it into two separate openings.
Women who have a double uterus often have
successful pregnancies. But the condition can increase the risk of miscarriage
or premature birth.
Symptoms
A double uterus often causes no symptoms. The
condition may be discovered during a regular pelvic exam or during imaging
tests to determine the cause of repeated miscarriages.
Women who have a double vagina along with a
double uterus may initially consult a doctor for menstrual bleeding that isn't
stopped by a tampon. In these situations, the woman has placed a tampon in one
vagina, but blood is still escaping from the second uterus and vagina.
When to see a doctor
Seek medical advice if you have a menstrual
flow despite the insertion of a tampon, or if you have severe pain with
menstruation or experience repeated miscarriages.
Causes
Doctors aren't certain why some fetuses
develop a double uterus and others don't. A genetic component may be a factor
because this rare condition sometimes runs in families.
Complications
Many women with a double uterus have normal
sex lives, pregnancies and deliveries. But sometimes a double uterus and other
abnormalities of uterine development are associated with:
·
Infertility
·
Miscarriage
·
Premature birth
·
Kidney problems
Diagnosis
A double uterus may be diagnosed during a
routine pelvic exam when your doctor observes a double cervix or feels an
abnormally shaped uterus. To confirm the diagnosis, your doctor may recommend
one or more of the following tests:
·
Ultrasound. This test uses high-frequency sound
waves to create images of the inside of your body. To capture the images, a
device called a transducer is either pressed against your abdominal skin or
inserted into your vagina (transvaginal ultrasound). Both types of ultrasound
may be done to get the best view. A 3-D ultrasound may be used where available.
·
Sonohysterogram. The sonohysterogram
(son-o-HIS-ter-o-gram), an ultrasound scan, is done after fluid is injected
through a tube into your uterus by way of your vagina and cervix. This allows
your doctor to look for problems in the shape of your uterus.
·
Magnetic
resonance imaging (MRI). The MRI machine
looks like a tunnel that has both ends open. You lie down on a movable table
that slides into the opening of the tunnel. This painless procedure uses a
magnetic field and radio waves to create cross-sectional images of the inside
of your body.
·
Hysterosalpingography. During a hysterosalpingography
(his-tur-o-sal-ping-GOG-ruh-fe), a special dye is injected into your uterus
through your cervix. As the dye moves through your reproductive organs, X-rays
are taken to determine the shape and size of your uterus and whether your
fallopian tubes are open.
Treatment
If you have a double uterus but you don't have
signs or symptoms, treatment is rarely needed. Surgery to unite a double uterus
is rarely done — although surgery may help you keep a pregnancy if you have a
partial division within your uterus and no other medical explanation for a
previous pregnancy loss.
If you have a double vagina in addition to a
double uterus, you might be a candidate for an operation that would remove the
wall of tissue separating the two vaginas. This can make childbirth a little
easier.
Preparing for your
appointment
You're likely to start by seeing your primary
care provider. You might be referred to a doctor who specializes in conditions
affecting the female reproductive tract (gynecologist) or a doctor who
specializes in reproductive hormones and optimizing fertility (reproductive
endocrinologist).
What you can do
To prepare for your appointment:
·
Ask
if there's anything you need to do in advance to prepare for any possible tests.
·
Make
a list of any menstrual symptoms you've had and for how long.
·
Make
a list of your key medical information, including any other conditions for which you're being
treated and the names of any medications, vitamins, herbs or supplements you're
taking.
·
Take
a family member or friend along, if possible, to help you remember everything.
·
Make
a list of questions to ask your
doctor to help you make the most of your visit.
Some basic questions to ask your doctor
include:
·
What is the most
likely cause of my signs and symptoms?
·
Are there any other
possible causes?
·
What treatment
approach do you recommend, if any?
·
Am I a candidate for surgical
treatment? Why or why not?
·
Am I at increased risk
of problems during pregnancy?
·
What options are
available to improve my chances of a successful pregnancy, if necessary?
·
Should I see a
specialist?
·
Are there any
brochures or other printed materials that I can have? What websites do you
recommend?
What to expect from
your doctor
Your doctor is likely to ask you a number of
questions. Being ready to answer them may reserve time to go over any points
you want to spend more time on. Your doctor may ask:
·
What are your signs
and symptoms, and when did you first notice them?
·
Are your signs and
symptoms continuous, or do they come and go?
·
Do you menstruate
regularly?
·
What is a typical
menstrual period like for you?
·
Have you ever been
pregnant?
·
If you have been
pregnant, what was the outcome?
·
Do you hope to have
biological children in the future?
·
Are you currently
being treated or have you recently been treated for any other medical
conditions?
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