Uncommon problems of the double uterus

Although often asymptomatic, congenital anomalies of the uterus may be associated with many gynaecological and obstetrical problems. The double uterus should always be considered in cases of severe dysmenorrhoea and chronic pelvic pain; in cases of the failure of intrauterine contraceptive devices; in cases of a symptomatic or asymptomatic pelvic mass that is inseparable from the uterus; in cases where termination of pregnancy has been unsuccessful; and in cases of cervical incompetence. Where uterine malformations are overlooked patients may not be treated properly before excessive fetal wastage occurs and may undergo extensive surgical procedures that may terminate fertility. Clinical suspicion, accurate documentation of curettage findings and the increased use of hysterography and, especially, ultrasound enable earlier diagnoses and the application of the correct treatment.