Uterus Bicornuate

A two-horned uterus (uterus bicornis) is an anatomical abnormality of the uterus, which is characterized by the presence of two uterine horns, or processes, attached to one wall of the pelvis. This rare pathology occurs in approximately 0.5-1% of women of fertile age. Uterus bicornuum usually does not cause symptoms, but in some cases it can be associated with infertility, miscarriage and complications during childbirth.

Two or more diverticula appear - protrusions of the walls of the uterus directed forward (protruding above the anterior wall of the vaginal vault). In some patients, one of the two lobes increases in size, so that it becomes displaced and closes the entrance to the vagina. The intramural part of the sections has a rocky structure, which can lead to swelling, overstretching and infection, including perforation. A deep gap is formed. As a result, the shape of the uterine cavity is disrupted and its position changes: it can be tilted, descending, dystopic, or anteversion. Most often, the pathology is diagnosed in utero, sometimes visualized by ultrasound in the first trimester of pregnancy. On vaginal examination, the uterus may feel normal; no pathology may be noticed, and symptoms of infertility may occur only after menopause. The presence of the anomaly does not affect a woman's fertility, although she may be subject to complications such as double rupture in the second and third trimesters or early premature rupture of membranes. Diagnosis of a bicornuate uterus can be done by transvaginal ultrasound or laparoscopy. The disease is often combined with bladder stenosis, which is manifested by very frequent urination and menstrual irregularities. Possible complications of a bicornuate uterus include chronic bladder infections and bowel disorders.

Treatment of a bicornuate uterus includes drug therapy and surgical methods. The most common treatment method is abdominal hysterectomy, that is, removal of the uterus along with the cervix. This applies to both adulthood and women still of childbearing age. Although lack of treatment is not associated with an increased risk of mortality, the rate for patients with this gynecological abnormality is higher than average. The optimal treatment strategy should be determined by a gynecologist and depends on the general health of the patient and the presence of concomitant diseases.