Uterine didelphys with duplicated upper vagina and bilateral lower vaginal agenesis: a novel Müllerian anomaly with options for surgical management  Whitfield B. Growdon, M.D., Marc R. Laufer, M.D.  Fertility and Sterility  Volume 89, Issue 3, Pages 693-698 (March 2008) DOI: 10.1016/j.fertnstert.2007.03.062 Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 1 (A) Schematic of patient A with asymmetric uterine didelphys with bicollis and duplicated obstructed hemivaginas, and bilateral agenesis of the lower vagina. (B) Coronal MRI of bilateral obstructed hemivaginas distended with old blood. (C) Sagittal section MRI demonstrating agenesis of lower vaginas, left caudad. (D) Intraoperative view demonstrating distended hemivaginas and bilateral hemiuteri. (E) Coronal section MRI showing distended right hemivagina, bicollis and normal ovaries. Fertility and Sterility 2008 89, 693-698DOI: (10.1016/j.fertnstert.2007.03.062) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 2 (A) Schematic of patients B and C with symmetric uterine didelphys with bicollis with lower agenesis of the vagina. (B) MRI of patient C demonstrating distended hemiuteri with bicollis. (C) MRI of patient C demonstrating parallel hemivaginas distended with old blood. (D) Coronal MRI of patient C demonstrating hemivaginas, bilateral hemiuteri, and normal ovaries. Fertility and Sterility 2008 89, 693-698DOI: (10.1016/j.fertnstert.2007.03.062) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions

Figure 3 (A) Patient A (13 years old) with asymmetric uterine didelphys with bicollis and duplicated obstructed hemivaginas, and agenesis of the lower vagina. (B) Anatomy after left hemivaginoplasty. (C) Anatomy after 3 months of vaginal dilator use and distension of right hemivagina with old blood. (D) Functional outcome after interval right hemivaginoplasty with resection of the resultant septum to the level of the caudad cervix. Fertility and Sterility 2008 89, 693-698DOI: (10.1016/j.fertnstert.2007.03.062) Copyright © 2008 American Society for Reproductive Medicine Terms and Conditions