Uterus Didelphys with Unilateral Imperforate Vagina and Ipsilateral Renal Agenesis

EDITORIAL COMMENT: We accepted this case for publication to remind readers that genital tract abnormalities are common; just about any combination of uterovaginal malformations, with or without retained menses, that can be imagined, has been reported, and many presentations are bizarre in both obstetric and gynaecological practice. We consider the authors are excessively self critical in condemning the laparotomy performed on this patient, although it is always wise to have the results of intravenous pyelography before laparotomy. The Editor also wishes to report a similar case he encountered with Dr. Peter Dobson at the Austin Hospital in 1979. The patient was a 14‐year‐old menstruating girl, who also presented with abdominal pain. At examination under anaesthesia a large mass was noted bulging into the vagina through the upper two‐thirds of the posterior wall; after discussion we aspirated the mass and when chocolate‐brown fluid blood was obtained the mass was incised and drained. There was no evidence of a second cervix or vaginal septum. Intravenous pyelography revealed a normal right‐sided and absent left kidney. At subsequent laparotomy a rudimentary left‐sided uterine horn was found and excised with more difficulty than anticipated. The patient had no further menstrual problems but had 2 subsequent episodes of urinary tract infection. She was next seen at the Mercy Maternity Hospital antenatal clinic in 1984; after a pregnancy complicated by hyperemesis, she had an outlet forceps delivery at 38 weeks' gestation, of a healthy but growth retarded male infant, birth‐weight 2,440 g, on September 18, 1984.