Background: The incidence of congenital uterine anomalies in the general population is estimated at 0.001-10%. Müllerian defects are associated with an increased incidence of urinary anomalies, an increased risk of infertility, early pregnancy loss, premature rupture of membranes, preterm labor and malpresentation.
Case: A 34-year-old, infertile woman with a presumed diagnosis of uterine didelphys and a longitudinal vaginal septum was noted to have a thin, communicating membrane separating the uterine horns on magnetic resonance imaging (MRI). A communication between these two horns was noted on hysterosalpingography (HSG). The diagnosis of complete uterine septum was therefore established. Uterine leiomyomata and a complete duplication of the right renal collecting system were also noted.
Conclusion: Cases of complete uterine and vaginal septum can be easily confused with uterine didelphys. Management of these two müllerian anomalies is different, with surgical correction usually needed in cases of complete uterine septum. The use of pelvic ultrasound, MRI and HSG aided in correctly diagnosing this unusual form of müllerian anomaly.