Retrospective analysis of anatomical uterovaginal (müllerian)‎ duct deformities and accompanied ovarian anomalies in a group of amenorrheic females

Abstract EN

Objective: Failure or incomplete fusion of the paired uterovaginal (Müllerian) ducts accompanied with a spectrum of uterine, cervical, and vaginal anomalies which are coexistent with obstruction and leading to amenorrhea.

The complex anatomy of ovaries and Müllerian ducts require complete assessment prior treatment.

This study aims to determine the frequencies of uterovaginal anomalies and that of ovarian anomalies in group of women presented with primary amenorrhea and to determine whether these Müllerian anomalies are associated with the ovarian anomalies in those patients.

In addition this study aims to identify the more frequent ovarian anomaly which was associated with uterovaginal anomalies in a group of patients presented with primary amenorrhea.

Methods: This retrospective study is done in Mosul medical college, University of Mosul, Mosul Province in Northern Iraq.

Data were collected from the medical reports of 82 women presented with history of primary amenorrhea.

Those women who attended to the hospital and in whom a laparoscopy was performed in order to evaluate the morphology of their ovaries, and uteruses.

Results: Gonadal agenesis/dysgenesis was shown in 28 (34.1%) out of 82 women presented with amenorrhea, while 45 (54.8%) women had got different uterovaginal anomalies.

Four women (4.8%) had got no uterus, while rudimentary uterus was shown in the reports of 6 (7.3%) cases.

Ten women (12.1%) had got infantile uterus, while absent uterus and upper vagina was shown in 8 (9.7%) women, and one case of aplasia in her uterus and cervix was reported.

On the other hand twelve cases (14.6%) had got vaginal transverse vaginal septum and or an imperforated hymen.

Eighteen cases (40.0%) out of 45 cases of anatomical uterovaginal anomalies were accompanied with ovarian abnormalities, the laparoscopic reports of five (11.1%) women revealed combined Müllerian agenesis and absent one or both ovaries, while absent uterus and ovaries were shown in one case (2.2%).

Nine women (20.0%) had got infantile uterus and bilateral streak ovaries.

On the other hand unilateral ovarian and tubal agenesis was shown in one (2.2%) woman.

Two cases of polycystic ovaries (4.4%) were accompanied with uterine anomalies one of them was a case of polycystic ovaries and rudimentary uterus while the another case of polycystic ovaries was accompanied with septate uterus.

The presence of testis instead of uterus and ovaries was reported in the pelvis of one case (1.2%).

Six (13.3%) out of 45 cases of uterovaginal anomalies was associated with ovarian agenesis, while 9 (20.0%) out of 45 cases of uterovaginal anomalies was associated with ovarian dysgenesis.

Conclusions: This study concluded that the gonadal agenesis was the first cause of the primary amenorrhea, while the transverse vaginal septum was the second cause.

The study concluded that the frequency of anatomical uterovaginal anomalies which are not associated with ovarian anomalies was higher than that accompanied with ovarian anomalies.

Ovarian dysgenesis was the more frequent ovarian anomaly which was accompanied with uterovaginal anomalies.