Congenital malformation of uterus
Many women are born with an abnormally shaped uterus which is responsible for the symptoms like menstrual abnormalities; infertility; recurrent pregnancy loss; pain etc.
Types of Uterine Malformations
ASRM ( American Society of Reproductive Medicines ) classification is as follows:
Class 1: Absent uterus
Uterus is absent or very small and unerdeveloped; vagina is also absent. It is also called MRKH syndrome .
Class 2: Unicornuate uterus or one sided uterus.
It forms due to half development of the uterus and appears typically like banana in imaging studies.
Class 3: Uterus didephys or double uterus
It forms due to failure of the fusion of mullerian ducts causing double uteri; double cervix and vaginal partition.
Class 4 : Bicornuate uterus
It forms due to failure of fusion of the upper part of mullerian system; leading to bifurcation of the upper part of the uterus.
Class 5: Septate uterus
It forms when the mullerian ducts fuse but the partition between them is still present. Thus splitting the the uterus. And this may include the cervix and vagina as well.
Usually the septum involve the upper part of the uterus and is a frequent cause of miscarriages.
Class 6: T shaped uterus
The inner cavity of the uterus in T shaped.
Another variant is arcuate uterus where there is a concave dimple at the top of the uterus called the fundus.
Rudimentary or undeveloped uterus or the remnant of the uterus may be found in the abdomen with these anomalies.
Many times patients with uterine anomalies have abnormalities of the kidney also.
Diagnosis of Congenital Abnormalities of the Uterus:
1. Physical examination
3. Pelvic MRI
4. HSG or hysterosalpingography
Treatment of Abnormally Shaped Uterus
The most commonly seen abnormalities of the uterus are:
3.T shaped uterus
All these abnormalities can be corrected by hysteroscopy namely; hysteroscopic septal resection; hysteroscopic septal division; and metroplasty .
The advantage of a hysteroscopic surgery is that it does not involve staying admitted in the hospital and you can be discharged on the same day. And it does not involve any stitches.
Davydov S Vaginoplasty
Davydov s vaginoplasty is a procedure done by laparoscopy and it is meant to develop new vagina in patients with MRKH syndrome in whom the uterus and vagina are either absent or maybe a very small undeveloped uterus.