Question of the day: A Class III Mullerian duct anomaly results from:

Question:

A Class III Mullerian duct anomaly results from:

	1. Segmental agenesis.
	2. Partial or complete hypoplasia.
	3. Complete nonfusion of the mullerian ducts.
	4. Partial nonfusion of the superior segments of the uterovaginal canal.
	5. Resorption of the uterovaginal septum.

Answer:

The correct answer for the question "A Class III Mullerian duct anomaly results from:" is:

3. Complete nonfusion of the mullerian ducts.

Explanation
Segmental agenesis is a Class I Mullerian duct anomaly. [Class I anomalies consist of segmental agenesis and a spectrum of uterovaginal hypoplasia. ]

Partial or complete hypoplasia is classified as a Class II anomaly. [Class II anomalies include unicornuate uteri, which includes both partial or complete hypoplasia.]

Complete nonfusion of the mullerian ducts is a Class III Mullerian duct anomaly. [Class III includes a spectrum known as uterus didelphys which duplication of the uterus is a result of complete nonfusion of the mullerian ducts.]

Partial nonfusion of the superior segments of the uterovaginal canal is classified as a Class IV anomaly. [Class IV anomalies only demonstrate partial nonfusion of the superior segments of the uterovaginal canal and are known as bicornuate uteri.]

Resorption of the uterovaginal septum is a Class V anomaly. [Class V anomalies are unique in that they represent disorders in resorption of the uterovaginal septum and include septate uteri.]

From the manuscript:
Uterus didelphys with unilateral distal vaginal agenesis and ipsilateral renal agenesis: Common presentation of an unusual variation
Radiology Case. 2011 Jan; 5(1):1-8

This article belongs to the OB/GYN section.

From the manuscript

Uterus didelphys with unilateral distal vaginal agenesis and ipsilateral renal agenesis: Common presentation of an unusual variation

Free full text article: Uterus didelphys with unilateral distal vaginal agenesis and ipsilateral renal agenesis: Common presentation of an unusual variation

Abstract
Mullerian duct abnormalities are congenital malformations that are easily missed and can lead to incorrect diagnosis and unnecessary operative procedures. In this case, a young female presented with cyclic pelvic pain that continued after previous surgical resection of an ovarian cyst. Further investigation with clinical examinations and multimodality imaging demonstrated ipsilateral renal agenesis and a Class III Mullerian duct anomaly (MDA) requiring a second operative procedure. It is believed that this case is a variant of the described obstructed hemi-vagina with ipsilateral renal agenesis (OVIRA) anomaly as pathologically there was ipsilateral renal agenesis and complete vaginal agenesis in our case. It is imperative to have a high clinical suspicion of mullerian duct abnormalities when encountering a patient with other urogenital anomalies. This will decrease the amount of misdiagnoses, guide appropriate surgical intervention, and decrease the risk of future reproductive complications.

References

1. Troiano RN, McCarthy SM. Müllerian duct anomalies: imaging and clinical issues. Radiology 2004; 233 (1)1:19-34.
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