Complex Mullerian Duct Anomalies in King Abdulaziz Medical City: A Report of Two Cases

Background:

Mullerian duct anomalies (MDA) are a set of uterovaginal malformations due to failure of organogenesis. Prevalence ranges between 0.16% to 10% globally. We present two cases that were diagnosed with rare and complex malformations at King Abdulaziz Medical City.

Case (1):

First case, a 13 years old girl, presented with dysmenorrhea and recurrent tract infections. MRI showed bicornuate bicollis uterus with transverse vaginal septum to the right lateral wall and CT showed right renal agenesis. Two surgical procedures were made 1) Laparoscopic right salpingectomy with vaginal septum dissection 2) Hysteroscopic uterine septum removal.

Case (2):

Second case, a 15 years old girl, presented with continuous vaginal bleeding. MRI showed didelphys uterus with ruptured transverse vaginal septum and right renal agenesis. At presentation, no surgical intervention was needed only medications were prescribed. After two weeks, the bleeding was not controlled, therefore a surgical evacuation was needed. 

Conclusion:

We observed that young females complaining of dysmenorrhea and prolonged periods can indicate uterine anomalies. As a result, magnetic resonance imaging is a useful technology for diagnosis. The outcomes of the malformations and the timing of intervention seriously affects conception and pregnancy.