Uterus didelphys with obstructed hemivagina and pyocolpos, ipsilateral tubal occlusion and renal agenesis, and bilateral cervical hypoplasia. A case report.

The diagnosis of uterus didelphys with an obstructed hemivagina and ipsilateral renal agenesis is uncommon prior to menarche. The rarity and unusual presentation of the condition may contribute to a diagnostic delay for months to years after menarche. We encountered such a patient, who also had a microscopic communication between the uterine horns, hypertrophy of the right uterine horn, apparent ipsilateral occlusion of the fallopian tube and bilateral cervical hypoplasia, a finding not previously noted in similar cases. The inability to utilize the cervix as a landmark, associated findings and the presence of chronic inflammation precluded definitive treatment during initial hysteroscopy and laparoscopy. Laparotomy was performed to fully ascertain the status of the right uterine horn and to determine which structures to resect.