A 35-year-old woman presented with severe lower abdominal pain and difficulty urinating. An ultrasound revealed she had two separate uteruses with separate cervical canals but a normal vaginal canal, consistent with a bicornate bicollis uterus. This type of uterus is a müllerian duct anomaly that can result from interrupted development of the müllerian ducts in utero. Müllerian duct anomalies are associated with renal, vertebral, and cardiac anomalies as well as infertility and menstrual disturbances.

1. Case presentation

2. A 35 years lady with h/o:
 Severe lower abdominal pain
 Difficulty in passing urine

7. Provisional diagnosis
• Two separate uterus with separate cervical
canal with normal vaginal canal
Bicornate bicollis uterus

8. D/D
• Bicornuate unicollis uterus
• Septate uterus
• Uterus didelphys
• Arcuate uterus

12. • Absence of a cleft in the external
uterine fundal contour with a
duplicated endometrial cavity is the
key feature used to diagnose a septate
uterus rather than a bicornuate uterus.

16. • The müllerian ducts are paired embryologic
structures that undergo fusion and resorption
in utero to give rise to the uterus, fallopian
tubes, cervix, and upper two-thirds of the v
vagina. Interruption of
• normal development of the müllerian ducts
can result in formation
• of müllerian duct anomalies (MDAs).

20. Associations
• renal anomalies, with a reported prevalence of
• 30%–50%, including renal agenesis (most
commonly unilateral agenesis), ectopia,
hypoplasia,
• fusion, malrotation, and duplication
• vertebral bodies
• (29%), such as wedged or fused vertebral bodies
• and spina bifida (22%–23%), cardiac anomalies
• (14.5%), and syndromes such as Klippel-Feil
• syndrome (7%)

21. Complications
• Menstrual distrubances
• Infertility
• Sexual distrubance

22. Reference