Double Uterus – Diagnosis and Treatment

A double uterus, also known as uterus didelphys, is a rare condition that develops before birth. In this condition, a person has two separate uteruses instead of just one.

When certain parts of the uterus do not join together during development, two uterine cavities form. Most people with a double uterus may not notice symptoms and may learn about the condition only during a medical exam or pregnancy.

Diagnosis

Doctors often find a double uterus and other congenital uterine anomalies during a regular pelvic exam.

During this checkup, a healthcare provider might notice two cervixes or feel a uterus with an unusual shape. When these signs appear, more tests help confirm what type of anomaly is present.

Main diagnostic methods include:

Test Name	Purpose
Pelvic Ultrasound	Check uterus shape and structure
Sonohysterogram	Detailed outline of uterine cavity
MRI	Clear images of pelvic organs
Hysterosalpingography	Uterus and fallopian tube structure

• Pelvic Ultrasound: This scan uses sound waves to create detailed pictures of the uterus. Both abdominal and transvaginal ultrasounds may be used to get the clearest view. Sometimes, a 3D ultrasound provides a more complete image.
• Sonohysterogram: A provider gently places fluid into the uterus with a thin tube. Next, an ultrasound highlights the inside shape of the uterus using the fluid. This method helps detect anything that looks unusual.
• Magnetic Resonance Imaging (MRI): An MRI provides cross-sectional images of pelvic organs. This painless scan gives very clear pictures, which can help distinguish between types of uterine anomalies, such as unicornuate, bicornuate, septate, or didelphic uterus.
• Hysterosalpingography: A provider places a special dye in the uterus and fallopian tubes, which shows up on X-rays. These images let doctors see the size and shape of the uterus and check if the fallopian tubes are open.

Doctors may order extra tests to check kidney health because some Müllerian duct anomalies can affect the kidneys.

For those who are pregnant or planning for pregnancy, early diagnosis helps manage risks and guides treatment choices. The main goal is to distinguish between similar conditions and make an accurate diagnosis.

Treatment

Most individuals with a double uterus do not require any treatment unless they are experiencing symptoms or complications.

Surgical correction may be considered if there is a history of pregnancy loss without another cause, or if a double vagina is present along with a double uterus.

In such cases, doctors may suggest a procedure to join the uterus or remove tissue between two vaginal canals to improve comfort and childbirth outcomes.

Other options like progesterone therapy or embryo transfer may be used in specific pregnancy-related situations. Sometimes, doctors recommend a cesarean section for delivery.

Getting Ready for Your Visit

Steps You Can Take Beforehand

Before meeting the doctor, prepare in advance. Taking a few simple steps can make the appointment go smoothly and help you feel more confident.

• Check for instructions. When scheduling the visit, ask if you need to do anything special before arriving. Some tests may require preparation.
• Write down your symptoms. List all health changes, even those that might not seem related. Be honest about anything unusual.
• Collect key personal details. This might include recent major events, family health history, or new stresses in your life.
• Track your medications. Bring a written list of all medications, vitamins, or supplements you take. Note how much and how often you take each one.
• Prepare your questions. Being ready with questions can help make sure you get the answers you need.
  Example questions:
  • What could be causing these symptoms?
  • Are there other possible reasons for my symptoms?
  • What tests might be needed?
  • Is any treatment necessary?
  • Are there other treatment options?
  • Do I need to follow certain rules or avoid anything?
  • Should I see a specialist?
• Bring support. If possible, have a trusted friend or family member come along. They can help listen, remember what is discussed, and support you.

Communicate openly. Let your provider know if you are uncomfortable or nervous. Ask about the tests or treatments and be sure you understand what will happen. If something is unclear, ask for an explanation in plain language.

Discuss consent for any exams or tests. You must know what will be done and agree to it. If you do not want a certain test or feel unsure, let your doctor know.

A simple checklist can be useful:

Task	Done?
Asked about prep steps needed
Listed all symptoms
Written down personal/family history
Made a medication/supplement list
Prepared questions
Asked someone to come with you
Ready to discuss consent and comfort

What Your Provider Might Ask or Do

During the appointment, the doctor will likely ask a range of questions to understand your health better. These questions may focus on the timing, severity, and type of symptoms. Be ready to talk about:

• When you first noticed symptoms
• How often you have them and how strong they feel
• If symptoms come and go or remain constant
• Your menstrual cycle, including if periods are regular
• Any pregnancies or childbirths in the past
• What helps or worsens your symptoms

Providers may talk about which tests they recommend. They will explain if an exam or imaging is needed. You should have time to decide if you are comfortable with any suggested tests.

The doctor might also ask about your medical and family history, medications, and lifestyle. If you feel nervous or unsure, let your provider know. The doctor should explain each step, ask for your consent, and respect your comfort.

If at any point you do not understand something, ask for more information or request a pause before moving forward.