Müllerian Duct Anomalies (MDA) are a broad category of congenital deformities of the urogenital structures due to abnormal development, fusion, or resorption of the fetal Müllerian Ducts. By definition, the Müllerian Ducts are the paired fetal structures that are located medially to the Wolffian Ducts and develop into the Fallopian Tubes, uterus, cervix, and upper two-thirds of the vagina. The multitude of symptoms associated with MDAs vary broadly in severity, ranging from patients with no symptoms and incidentally discovered MDAs to patients with primary infertility, recurrent pregnancy loss and other reproductive problems. There are well documented associations of MDAs with other genitourinary malformations. The most commonly reported is renal agenesis, which accounts for up to 30% of all associated renal anomalies in the setting of MDA, however abnormalities including ureteral remnants with ectopic insertion or collecting system duplication have been reported as well. The overall incidence of MDAs varies, but have been estimated to be approximately 1-5% within the general population and up to 13-25% in patients with recurrent pregnancy loss. The most commonly accepted system of classification of the various types of MDAs is that of the American Fertility Society, which divides MDAs into seven categories. However, there is often confusion as to how to categorize MDAs demonstrating characteristics of more than one class. Medical imaging is of essential importance for both this reason and for appropriate planning of therapy. The imaging of suspected MDAs involves the implementation of a combination of 3D Ultrasound, Magnetic Resonance Imaging, Sonohysterography, Hysterosalpingraphy and/or laparoscopy. Sonography and MRI have the benefits of being the least invasive methods of diagnosis. The goal of our educational exhibit will provide an overview of the embryology and pathophysiology related to a broad variety Müllerian Duct Anomalies. We will discuss the common imaging techniques employed in the workup of patients with Müllerian Anomalies. In addition, we provide a plethora of interesting cases from our home institution including a case of Mayer-Rokitansky-Küster-Hauser Syndrome, Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA), cloacal abnormality, bicornuate uterus and other complex cases utilizing a variety of imaging modalities.
SPR 2019 Annual Meeting & Postgraduate Course
Mullerian Duct Anomalies,