Double vagina and cervix communicating bilaterally with a single uterine cavity: report of a case with an unusual congenital uterine malformation.
BACKGROUND
The existence of a longitudinal vaginal septum with double cervix communicating bilaterally with a nonseptate uterine body and normal adnexa is an unusual müllerian anomaly.


METHODS
A 43-year-old woman presented with menorrhagia and duplication of the cervix and vagina. Afibromatous uterus was suggested by clinical examination and confirmed by ultrasonography. The patient underwent total abdominal hysterectomy with bilateral salpingooophorectomy. The surgical specimen revealed a fibromatous uterus with double cervix communicating bilaterally with a nonseptate uterine body; both adnexa were normal.


CONCLUSIONS
This rare müllerian anomaly is inconsistent with the classical embryologic theory of caudal to cranial müllerian development but supports the alternative embryologic hypothesis suggested by Müller et al, according to which fusion and absorption begin at the isthmus and proceed simultaneously in both the cranial and caudal directions.
Varras
Michail
M
Department of Obstetrics and Gynecology, Tzaneio General State Hospital, Third District National Health System, Peraeus, Greece. mnvarras@otenet.gr
Akrivis
Christodoulos
C
Demou
Asimo
A
Kitsiou
Evangelia
E
Antoniou
Nikolaos
N
D000328:Adult; D002584:Cervix Uteri / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery; D010052:Ovariectomy; D014599:Uterus / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000196:embryology / Q000601:surgery