Uterine malformation
A uterine malformation is the result of an abnormal development of the Mullerian duct(s) during embryogenesis. The range of impact reaches from amenorrhea, infertility, pain, to normal functioning pending on the character of the defect. Uterine malformations affect about 1% of the female population.
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Types
The American Fertility Society (now American Society of Reproductive Medicine) Classification distinguishes:
- Class I: Mullerian agenesis (absent uterus).
- Class II: Unicornuate uterus (a one-sided uterus).
- Class III: Double uterus (uterus didelphys).
- Class IV: Bicornuate uterus: uterus with two horns.
- Class V: Septated uterus (uterus has a partition or septum).
- Class VI: DES uterus
An additional variation is the arcuate uterus. A rudimentary uterus is an uterine remnant not connected to cervix and vagina and may be found on the other side of an unicornuate uterus.
Diagnosis
Besides a physical examination, the physician will need imaging techniques to determine the character of the lesion: gynecologic ultrasonography, pelvic MRI, or hysterosalpingography. In addition, laparoscopy and/or hysteroscopy may be indicated. In some patients the vaginal development may be affected. Studies may have to address if other organs systems are affected (kidneys, spinal bone column).
Treatment
Surgical intervention depends on the extent of the individual problem.