Author: Sister Sa (attending doctor of obstetrics and gynecology)
If someone said that he was born with two dicks, and they were both 25.4 cm in length, and they could be used normally, would you be unable to control your desire to “seeing is believing” quickly ?
The day before yesterday, Sister Sa saw an article by her old friend Lilac Garden, and told everyone a story about “Three Shots”, a disease about multiple penis-“Penile duplication” Diphallia, a type of penile malformation, is an extremely rare developmental abnormality in which patients are born with multiple penis.
Image source: Zhanku Hailuo
This article also reminded me of a real experience I met with a woman who had a double vagina and double uterus.
Speaking of which, it is also surprising. Before the pregnancy, the girl didn’t even know she had this problem, because she has been menstruating like everyone else. She comes and goes normally every month, and the same room is also normal. The same, the pregnancy is also normal, the result is pregnant and a checkup, the doctor found:
Why is there a uterus next to this?
Check again: No, the vagina is also two!
In the case of double tincture in males, in females, double uterus is also a duplication of reproductive structure. During the developmental period of the fetus, if the two Failure to fuse the mullerian ducts results in a double uterus.
But we don’t know why the two tubes failed to fuse, and women with this type of deformity, like men with multiple penis, often have normal karyotypes. .
Generally, this duplication is limited to the uterus and cervix, i.e., the uterus and cervix, but it can also occur in the vulva, bladder, urethra, vagina, and anus, such as The pregnant woman I saw had double uterus and double vagina, but no obvious abnormality was found from the vulva.
In 15%-20% of women with this reproductive structure, unilateral anomalies, such as those associated with obstructive hemi-vaginal uterus, can also be present , and ipsilateral kidney loss, with the deformity located on the right side in 65% of cases.
Double uterus is not difficult to diagnose, usually it can be seen by B-ultrasound. B-ultrasound is not only relatively inexpensive, but also relatively simple to operate.
Congenital uterine malformations are also divided into many types. In addition to double uterus, there are also common septate uterus and bicornuate uterus. During ultrasonography, in addition to evaluating the outside of the uterine fundus Contouring, the kidneys also need to be evaluated for related abnormalities.
If looking at something else, then consider other tests, such as a hysterosalpingogram (HSG), which can show the patency of the fallopian tubes and the size and structure of the uterine cavity. Both saline infusion hysterography and HSG can well demonstrate the morphology of the uterine cavity.
For a double uterus, under the B-ultrasound image, two far apart uterine horns can be seen with a deep fundus depression, and the doctor can check through a speculum , found 2 cervix. However, in difficult cases, MRI may be required to better visualize complex deformities;
Vaginal B-ultrasound is relatively clearer for exploration, and MRI can be considered for young women who cannot tolerate or refuse 3D ultrasound diagnosis with vaginal probes.
How does twin uterus affect fertility?
Yes, first of all, in terms of pregnancy, although pregnancy itself may not have such a big impact, it is reported that the spontaneous abortion rate of patients with twin uterus is 32%, and the premature birth rate is 32%. 28%.
There is also an increased risk of fetal growth restriction in this condition. In fact, it is not difficult to understand. After all, there is only one piece of land, and only one building is a luxury villa. Building two buildings is at most a villa level, and the resources enjoyed are different. Another type of septate uterus is similar. the truth.
Image source: Zhanku Hailuo
It is also relatively uncommon for women with double uterus to have two vaginas that are completely separated, as a vaginal septum is present in about 75% of cases.
The vaginal septum is like the middle of the original four-lane road. If a guardrail is erected for you, the width of the road will be greatly reduced. It may not only affect the outflow of menstrual blood, but also cause sexual intercourse. Difficulty or difficult vaginal delivery.
Many people didn’t notice it when they were young, but when they tried to have sex in adulthood, they discovered this problem and only found out when they went to the hospital for examination.
Will Auntie come again?
Answer: Yes.
Even a woman with a vaginal obstruction on one side and a missing kidney on the same side can still have regular periods because menstrual blood from one uterus can still pass through the unobstructed side of the cervix and discharge from one side of the vagina.
However, because the journey is often not smooth, these patients may often experience periodic pain due to the accumulation of blood on the obstructed side of the vagina.
Another effect is that if there is a “micro-penetration” between the unobstructed side of the vagina and the obstructed side, infection on the obstructed side may result. Complete bilateral obstruction may also occur, in which case the menstrual flow cannot flow, manifesting as primary amenorrhea.
In terms of treatment, the most common and effective method is to choose removal of the vaginal septum. Treatment often involves excision of the obstructing vaginal wall and subsequent creation of a single vaginal fornix. However, hysteroplasty should also be considered in women with pelvic pain, recurrent spontaneous abortion, or previous preterm labor.
The existing data is not enough to support open repair of double uterus to improve pregnancy outcome. If the condition of double uterus does not have any impact on life, then the original normal life can be maintained first. .
For example, the girl that Sister Sa met, even if she was lucky, because she had two relatively complete sets of structures, her aunt was usually normal, and she was lucky enough to be pregnant. At full term, after giving birth, no problems were found in the reexamination, so I went home with the baby.
However, we did give her a few words when she was discharged from the hospital.
What are you asking?
You think, others have one set of “equipment”, she has two sets, and she will not talk about it after the child is born. If you don’t want a child, then on the issue of contraception, just Need to be considered.
The difference is that these two sets of equipment must be considered, because they may have normal functions, and it is possible to alternate ovulation and alternate aunts, in case one is ready If you come up with a set of countermeasures and accidentally enter the wrong door, the other set still has the output function, and accidents may still occur.
So at this time, it is not very suitable to use an intrauterine contraceptive ring for contraception. The last one, she needs two, not to mention the high cost. In case of discomfort, such as irregular vaginal bleeding, it may be two.
So at this time, it may be better for men to take a method and hold it.
After all, another source to stop is the solution. It’s like the factory resumes work, even if there are two sets of equipment working at the same time here, and there is no channel for supplying raw materials, forgive you that the output will not be normal!
References:
[1]Grimbizis GF, Camus M, Tarlatzis BC, et al. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update 2001; 7:161.
[2]Venetis CA, Papadopoulos SP, Campo R, et al. Clinical implications of congenital uterine anomalies: a meta-analysis of comparative studies. Reprod Biomed Online 2014; 29:665.< /p>
[3]Ludmir J, Samuels P, Brooks S, Mennuti MT. Pregnancy outcome of patients with uncorrected uterine anomalies managed in a high-risk obstetric setting. Obstet Gynecol 1990;75:906.
[4]Vercellini P, Daguati R, Somigliana E, et al. Asymmetric lateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil Steril 2007;87:719.
[5]Smith NA, Laufer MR. Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up. Fertil Steril 2007;87:918.
[6]Stassart JP, Nagel TC, Prem KA, Phipps WR. Uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis: the University of Minnesota experience. Fertil Steril 1992; 57:756.
* This article is reproduced with the authorization of the WeChat public account Doctor Girl Zhengzhuan.