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Mullerian Duct Anomalies is a gynecological condition that occurs in 2 to 3% of all women. However in women with recurrent abortion, the incidence of Mullerian Duct Anomalies can be as high as10 to15%. Surgical Management of Mullerian Duct Anomalies includes diagnosis, evaluation and treatment of this condition. The mullerian duct anomalies are a rare cause of infertility in women and are often is treatable. Mullerian Duct Anomalies are often related with abnormalities of the axial and renal skeletal systems. These abnormalities are frequently first encountered when the patients are first tested for associated conditions.
For the proper surgical management of Mullerian duct anomalies, various evaluation procedures are implemented. Patients having mullerian duct anomalies have a higher rate of infertility, growth retardation of fetal intrauterine, frequent first trimester spontaneous abortions, preterm labor, fetal malposition and retained placenta. Usually mullerian duct defects involve the uterus and vagina. These mullerian duct anomalies are easily corrected by means of surgical procedures. The most widely accepted technique of classifying Mullerian duct anomalies (MDAs) is the AFS classification of 1988. According to the major uterine anatomic defect, the AFS classification system categorizes mullerian duct anomalies.
The present AFS classification of Mullerian duct anomalies includes the following 7 classes:
- Segmental or complete agenesis or hypoplasia
- Unicornuate uterus with or without a rudimentary horn
- Didelphys uterus
- Complete or partial bicornuate uterus
- Complete or partial septate uterus
- Arcuate uterus
- DES-related abnormalities
| The surgical management of Mullerian duct anomalies is organized in accordance with its AFS classification. Vaginal agenesis or mullerian agenesis is an uncommon anomaly, which is characterized by hypoplasia or the absence of the proximal vagina, uterus and sometimes the fallopian tubes. Diagnosis of vaginal agenesis is generally done at puberty, when the patients present with primary amenorrhea to the gynecologist.
In the surgical management of Mullerian duct anomalies, few examinations are conducted. In order to diagnose vaginal agenesis, a pelvic examination may be done, which often reveals a patulous urethra.
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| Ultrasonographic reports can also support clinical findings related to Mullerian duct anomalies.Surgery is considered to be the most effective means of treating vaginal agenesis. The objective of a surgical treatment of Mullerian duct anomalies is to create a neovagina. Different methods of vaginal reconstruction have developed, and over 100 diverse surgical procedures have been reported.
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