Duplication of the müllerian ducts and genitourinary malformations. Part II: analysis of malformations.

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Abstract
Forty-seven females with duplication of the uterus and cervix were retrospectively studied to obtain a better understanding of the reasons for failure of fusion of the muellerian ducts by analyzing the associated genitourinary malformations. Thirty-one of the 47 patients had major genitourinary malformations that corresponded to 3 main complexes of anomalies. Cloacal anomalies were present in 16 patients, exstrophy in 2 and combined cloacal and exstrophic deformities in another 2. Renal malformations ipsilateral to a unilateral occluded muellerian duct were seen in 11 patients, and in 4 of these an ectopic ureter opened into the occluded duct. From the analysis of these anomalies it is proposed that duplication of the female genital system, when not an isolated event, may be secondary to interference with the normal process of muellerian fusion by a persistent cloacal duct, an abnormal pelvic girdle or an ectopic ureter.