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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

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Vaginal Abnormalities: Fusion and Duplication Glossary
  • abdominal: in the abdomen, the cavity of this part of the body containing the stomach, intestines and bladder.

  • anatomy: The physical structure of an internal structure of an organism or any of its parts.

  • bicornate uterus: Uterus that has two horns and is shaped like a heart.

  • bladder: The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.

  • cervix: The lower, narrow part of the uterus (womb).

  • diagnosis: The process by which a doctor determines what disease or condition a patient has by studying the patient's symptoms and medical history, and analyzing any tests performed (e.g., blood tets, urine tests, brain scans, etc.).

  • embryo: A human offspring in the early stages following conception up to the end of the eighth week.

  • embryonic: Related to an embryo, an offspring in the early stages of development following conception up to the end of the eighth week.

  • embryonic ducts: Narrow, tubular passageways within human offspring within the early stages of development from conception up to the end of the eighth week.

  • fallopian tubes: There are two fallopian tubes, one on each side of the uterus. They transport an egg from the ovary to the uterus.

  • fertility: The ability to conceive and have children.

  • incision: Surgical cut for entering the body to perform an operation.

  • ions: Electrically charged atoms.

  • mullerian duct: One of a paired structures adjacent to the developing gonads which have the potential to form fallopian tubes, the uterus and the upper portion of the vagina.

  • pregnancy: The condition of being pregnant.

  • pus: The yellowish or greenish fluid that forms at sites of infection.

  • septum: Thin membrane dividing something into two or more cavities.

  • ultrasound: Also referred to as a sonogram. A technique that bounces painless sound waves off organs to create an image of their structure to detect abnormalities.

  • urge: Strong desire to urinate.

  • urologist: A doctor who specializes in diseases of the male and female urinary systems and the male reproductive system. Click here to learn more about urologists. (Download the free Acrobat reader.)

  • urology: Branch of medicine concerned with the urinary tract in males and females and with the genital tract and reproductive system of males.

  • uterus: A hallow, muscular organ in the pelvis cavity of females in which the embryo is nourished and develops before birth.

  • uterus didelphys: A double uterus.

  • uterus duplex bicollis: Uterus with two cervixes.

  • vagina: The tube in a woman's body that runs beside the urethra and connects the uterus (womb)to the outside of the body. Sometimes called the birth canal. Sexual intercourse, the outflow of blood during menstruation and the birth of a baby all take place through the vagina.

  • vaginoscopy: Inspection of the vagina with an instrument.

Vaginal Abnormalities: Fusion and Duplication Anatomical Drawings

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