Vaginal Abnormalities: Fusion and Duplication
Having two of everything may be normal when you are talking about eyes, ears, hands and feet, but in the female reproductive system, a doubling of certain organs — such as the uterus, cervix, and vagina — is not a welcome turn of events. What happens to cause these rare abnormalities? The following information should help you understand the whys and wherefores if your child's doctor diagnoses an "anomaly of fusion and duplication."
What causes vaginal fusion and duplication?
Much of the female reproductive system is derived from two structures, known as mullerian ducts — a pair of embryonic ducts that evolve into the fallopian tubes, uterus and vagina in females. They come together during the ninth week of pregnancy. If this process is prevented or interrupted, "fusion" or "duplication" anomalies occur. In uterus didelphys, for instance, the patient has two each of a uterus, cervix and vagina. While one vagina is obstructed, the other remains unblocked and the external sex organs appear normal. In uterus duplex bicollis, the patient again has two each of a uterus and cervix, but only one vagina. In bicornate uterus, the patient has two uteruses fused with one cervix and one vagina.
How are vaginal fusion and duplication diagnosed?
The diagnosis of fusion abnormalities at times occurs in newborns with obvious abdominal lumps on external examination. An ultrasound will usually reveal a lump that pushes the bladder forward and the vagina backwards.
It is also common for women with complete vaginal duplication and blockage to be diagnosed at the time of puberty. Despite having their periods, a girl will experience discomfort accompanied by an abdominal lump. This lump is due to the buildup of menstrual fluid in the blocked vagina.
When a fusion anomaly is suspected, an examination called a vaginoscopy will be done — a scope is inserted into the vagina to enable the surgeon to see the anatomy.
How is vaginal fusion and duplication treated?
Treatment for fusion abnormalities depends on a patient's anatomy. If there is complete vaginal duplication with blockage, the urologist will perform a simple incision of the obstructing septum, allowing the fluid to drain. In some cases, the procedure is technically difficult so more extensive surgery is required.
Frequently asked questions:
How will this affect our child's fertility in the future?
Your child's fertility will not be affected.
Will our daughter have normal menses?
Yes. Menstruation should not be affected.
Reviewed: January 2011
Last updated: April 2013