Duplication of the müllerian ducts and genitourinary malformations. Part I: the value of excretory urography.

Forty-seven females with duplication of the uterus and cervix were retrospectively studied and their associated urinary tract malformations were analyzed. In 31 of the patients duplication of the müllerian ducts was diagnosed during the work-up for major genitourinary malformations that corresponded to three main complexes of anomalies: cloacal anomalies (16 patients), exstrophic deformities (4 patients), and renal malformation on the same side as an occluded müllerian duct (11 patients). Another five patients with normal kidneys had incomplete müllerian duct fusion discovered incidentally at autopsy, surgery, or during the work-up for urinary tract infections. None of the 11 women examined by excretory urography following the discovery of duplication of müllerian ducts by hysterosalpingography had urinary tract abnormalities. Therefore, although failure of fusion of the müllerian ducts frequently coexists with other genitourinary anomalies, the associated malformations manifest themselves clinically. Women who are found to have duplication of the reproductive tract during the work-up for infertility and who are otherwise asymptomatic and have a normal physical examination do not require urographic investigation.