Uterine Duplication

Uterine duplication is when a girl is born with a double uterus, a uterus with two separate cavities.

The condition is sometimes referred to as uterus didelphys.

Patients can be seen by Texas Children's experts in Pediatric and Adolescent Gynecology.

Causes & Risk Factors

Uterine duplication occurs when the uterus doesn’t develop properly in the fetus.

Normally, the uterus is formed by two tubes that join together to create one hollow organ. When these tubes fail to join together properly, it can result in uterine duplication. The cause of this abnormal development is not yet known.

Each cavity in a double uterus may lead to its own cervix. In some cases women with a double uterus also have a duplicate vagina. The vagina may develop properly on both sides or one vagina can be obstructed.

Symptoms & Types

In some cases, girls may have a double uterus and not be aware of it.

When symptoms do occur they may include:

  • Unusual pain before or during a menstrual period
  • Abnormal bleeding during a period, even when tampons are used
  • Infertility or complications during pregnancy and delivery 

Diagnosis & Tests

When two vaginas develop properly, the condition often has no symptoms and in many cases it goes undetected unless there are complications getting or staying pregnant.

When one vagina develops improperly, patients may present with periods but have progressively worsening pain. Diagnosis starts with a thorough medical history and physical exam, including a pelvic exam. During the pelvic exam, the doctor may discover a double vagina and double cervix, prompting additional testing including:

  • Imaging – such as ultrasound, MRI (magnetic resonance imaging)or hysterosalpingography (an x-ray that uses dye injected into the uterus) to look for uterine abnormalities
  • Hysteroscopy – uses a tiny telescope, called a hysteroscope, inserted through the vagina into the uterus to view and treat areas of concern
  • Vaginoscopy – uses a tiny telescope inserted into the vagina to view the vaginal vault and cervix

Treatment & Care

Treatment is typically not necessary unless the condition causes symptoms or if a woman is pregnant or trying to get pregnant.

Treatment strategies are then focused on improving fertility and reducing the chance of complications during pregnancy, including preterm delivery, miscarriages or breech births (feet first).