Two separate cervices, joining together at the level of the vagina, were found on the caudal scans. Diagnosis Uterus didelphys with right hematometrocolpos. The diagnosis was proven by the drainage of the hematometrocolpos. The embryological development of the urinary and genital tract is interdependent and the renal agenesis is always associated with the genital tract malformation. Uterus didelphys results from the nonfusion of the m llerian ducts and the persistence of the intervaginal septum.
Vaginal obstruction is due to the partial reabsorption of the septum.
The MRI appearance of the uterus didelphys consists of double, separate, uterus, cervix and upper vagina. A concomitant right hematometrocolpos, due to the obstruction of the vaginal septum, may be detected. The clue for the diagnosis is provided by the presence of a double endometrium, one of which usually appears very thickened because of the hematometra. On the other hand hematometra and hematocolpos are easily recognizable by the increased signal intensity on T1 e T2 weighted images. Either sagittal or coronal images may be very useful for the demonstration of the vaginal septum, obstructing the cervix.