Müllerian duct anomalies

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Müllerian duct anomalies (MDAs) are congenital abnormalities that occur when the Müllerian ducts (paramesonephric ducts) do not develop correctly. This may be as a result of complete agenesis, defective vertical or lateral fusion, or resorption failure.

Epidemiology

MDAs are estimated to occur in 1-5% of all women. There is a higher rate of women with repeated miscarriages (3-15%) ^2,5.

Clinical presentation

Despite these anomalies being common ¹, the majority are asymptomatic. Obstruction of the Müllerian duct may occur, and patients present with an abdominal mass and dysmenorrhea. Delayed treatment may result in severe consequences and potentially infertility. Patients may also present with recurrent miscarriages and infertility^2,5.

Pathology

Subtypes

The Müllerian duct anomaly classification ~~system~~ system divides them according to clinical manifestations, prognosis, and treatment. Accurate diagnosis is essential, since management varies according to the type of malformation.

~~Obstruction of the Müllerian duct may occur: patients present with an abdominal mass and dysmenorrhea. Delayed treatment may result in severe consequences and potentially infertility.~~

~~Pathology~~

~~Associations~~

~~Renal anomalies are frequently associated~~

~~Sub types~~

uterine agenesis: ~10%
arcuate uterus: often considered as part of normal anatomical variation, ~7%
unicornuate uterus: ~5~15% (range 5-25%)
uterine duplicational anomalies
- uterus didelphys: ~5~7.5 % (range 5-11%)
- bicornuate uterus: ~~~10~~~25% (range 10-39%)
- septate uterus: ~~~34~~~45% (range 34-55%)

Associations

Renal anomalies are frequently associated, most commonly renal agenesis but also crossed fused renal ectopia, and duplex kidney².

Radiographic assessment

Ultrasound

should be performed initially
confirms any structural abnormalities of the genital tract
sometimes cannot help to identify the type of MDA

MRI

valuable ~~non invasive~~noninvasive technique
evaluation of the female pelvic anatomy
accurate MDA classification

Treatment and prognosis

Many patients are asymptomatic and require no treatment. However, where obstruction occurs, surgical intervention is usually required and may result in permanent infertility: counseling is required.

-<p><strong>Müllerian duct anomalies (MDAs)</strong> are congenital abnormalities that occur when the <a href="/articles/muellerian-duct">Müllerian ducts </a>(paramesonephric ducts) do not develop correctly. This may be as a result of complete agenesis, defective vertical or lateral fusion, or resorption failure.</p><h4>Clinical presentation</h4><p>Despite these anomalies being common <sup>1</sup>, the majority are asymptomatic. The <a href="/articles/mullerian-duct-anomaly-classification">Müllerian duct anomaly classification</a> system divides them according to clinical manifestations, prognosis, and treatment. Accurate diagnosis is essential, since management varies according to the type of malformation.</p><p>Obstruction of the Müllerian duct may occur: patients present with an abdominal mass and dysmenorrhea. Delayed treatment may result in severe consequences and potentially infertility.</p><h4>Pathology</h4><h5>Associations</h5><p>Renal anomalies are frequently associated</p><h5>Sub types</h5><ul>
+<p><strong>Müllerian duct anomalies (MDAs)</strong> are congenital abnormalities that occur when the <a href="/articles/muellerian-duct">Müllerian ducts </a>(paramesonephric ducts) do not develop correctly. This may be as a result of complete agenesis, defective vertical or lateral fusion, or resorption failure.</p><h4>Epidemiology</h4><p>MDAs are estimated to occur in 1-5% of all women. There is a higher rate of women with repeated miscarriages (3-15%) <sup>2,5</sup>. </p><h4>Clinical presentation</h4><p>Despite these anomalies being common <sup>1</sup>, the majority are asymptomatic. Obstruction of the Müllerian duct may occur, and patients present with an abdominal mass and dysmenorrhea. Delayed treatment may result in severe consequences and potentially infertility. Patients may also present with recurrent <a href="/articles/miscarriage">miscarriages</a> and <a href="/articles/infertility">infertility</a> <sup>2,5</sup>. </p><h4>Pathology</h4><h5>Subtypes</h5><p>The <a href="/articles/mullerian-duct-anomaly-classification">Müllerian duct anomaly classification</a> system divides them according to clinical manifestations, prognosis, and treatment. Accurate diagnosis is essential, since management varies according to the type of malformation.</p><ul>
~~-<a href="/articles/unicornuate-uterus">unicornuate uterus</a>: ~5-25%</li>~~
+<a href="/articles/unicornuate-uterus">unicornuate uterus</a>: ~15% (range 5-25%)</li>
~~-<a href="/articles/uterus-didelphys">uterus didelphys</a>: ~5-11%</li>~~
+<a href="/articles/uterus-didelphys">uterus didelphys</a>: ~7.5 % (range 5-11%)</li>
~~-<a href="/articles/bicornuate-uterus">bicornuate uterus</a>: ~10-39%</li>~~
+<a href="/articles/bicornuate-uterus">bicornuate uterus</a>: ~25% (range 10-39%)</li>
~~-<a href="/articles/septate-uterus">septate uterus</a>: ~34-55%</li>~~
+<a href="/articles/septate-uterus">septate uterus</a>: ~45% (range 34-55%)</li>
~~-</ul><h4>Radiographic assessment </h4><h5>Ultrasound</h5><ul>~~
+</ul><h5>Associations</h5><p>Renal anomalies are frequently associated, most commonly <a title="Renal agenesis" href="/articles/renal-agenesis">renal agenesis</a> but also <a title="Crossed fused renal ectopia" href="/articles/crossed-fused-renal-ectopia">crossed fused renal ectopia</a>, and <a title="Duplex kidney" href="/articles/duplex-collecting-system">duplex kidney</a> <sup>2</sup>. </p><h4>Radiographic assessment </h4><h5>Ultrasound</h5><ul>
~~-<li>valuable non invasive technique</li>~~
+<li>valuable noninvasive technique</li>

References changed:

5. Behr S, Courtier J, Qayyum A. Imaging of Müllerian Duct Anomalies. Radiographics. 2012;32(6):E233-50. <a href="https://doi.org/10.1148/rg.326125515">doi:10.1148/rg.326125515</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23065173">Pubmed</a>

Tags changed:

anatomy
variant

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