[Ultrasonographic features and clinical diagnosis of Müllerian-Wolffian duct combined anomalies: case series and literature review].

Authors

S J Li, R Huang, L M Yang, D M Song, X W Huang

Published in

Zhonghua yi xue za zhi. Volume 106. Issue 38. Pages 4177-4180. Oct 20, 2026.

Abstract

To summarize the ultrasonographic features and causes of misdiagnosis of Müllerian-Wolffian duct combined anomalies and to evaluate their clinical diagnostic value through a literature review. A retrospective analysis was performed on the clinical data and three-dimensional transvaginal sonographic findings of 5 patients with surgically confirmed Müllerian-Wolffian combined anomalies treated at Fuxing Hospital, Capital Medical University, from March 2021 to December 2025. Relevant case reports were retrieved from PubMed, Google Scholar, Wanfang Data, VIP, and CNKI from database inception to December 31, 2025 for literature review. Five cases were included, with a median age of 21 (16, 37) years; 1 patient was married and 4 were unmarried. The main clinical manifestations included dysmenorrhea, prolonged menstruation, abnormal vaginal discharge, postmenstrual spotting, and infertility. Ultrasonography achieved a diagnostic concordance rate of 100.0% for uterine malformation type and unilateral renal agenesis, but showed limited accuracy in identifying cervical diverticula and cervical communicating tracts. Some paracervical cystic lesions were misdiagnosed preoperatively as cervical cysts, and were confirmed intraoperatively to be mesonephric or ureteric remnant-related lesions. All 5 patients underwent combined hysteroscopic and laparoscopic exploration followed by individualized minimally invasive treatment, and all symptoms were relieved after surgery. Additionally, a total of 9 cases were identified from the literature review. Preoperative imaging was generally accurate in identifying uterine malformation types. Magnetic resonance imaging (MRI) and hysterosalpingography (HSG) provided additional value in evaluating cervical canal patency, cervicovaginal communication, and complex mesonephric-related anomalies; however, some complex cases still required confirmation by hysteroscopic and laparoscopic exploration. Müllerian-Wolffian combined anomalies are frequently associated with occult cervical abnormalities and mesonephric-derived lesions. Three-dimensional transvaginal sonography combined with urinary system evaluation may improve initial screening and preoperative diagnosis, and provide a basis for individualized uterus-preserving minimally invasive treatment.

PMID:
42907216
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.

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