RUDIMENTARY UTERUS. — The rudi mentary uterus may be of any size from a cylinder-shaped body an inch long down to a slight thickening of tissue on the posterior surface of the bladder at the junction of the rudimentary Fallo pian tubes. It is usually solid, although in rare instances it takes the shape of a membranous sac. One or both ovaries may be present, usually also in a rudi mentary state. The vagina may be de veloped, but is ordinarily represented by a shallow, blind pouch. The vulva is apt to be normal in appearance.
About the end of the eighth week of foetal life Mueller's ducts begin to unite, the united lower portions forming the uterus and vagina, the upper ununited portions the Fallopian tubes. As a result of interference with the development during the process of union, which is complete at the end of the third month, various malformations have been found: The ONE-HORNED UTERUS indicates an arrested development of one of Mueller's ducts. The organ is more or less fusi form in shape, and curves toward the corresponding Fallopian tube. The other side is usually represented by a rudiment ary horn.
The TWO-HORNED UTERUS represents a want of perfect union of the ducts. The defect may involve the fundus only or may cause a flattening (uterus planifun dus) or slight depression of the fundus, or it may extend downward any distance toward the cervix (uterus bicornis uni collis), or it may extend into the cervix (uterus bicornis bicollis). Sometimes a septum divides the uterus (and sometimes the vagina) below the junction.
The DOUBLE 'UTERUS results when the union of Mueller's ducts does not take place above the vagina. The two sides are entirely distinct, but the vagina may be single or double or septate.
The TWO-CHAMBERED UTERUS is more or less normal in size and shape, but the septum persists, and may not extend as far down as the internal os (uterus sub septus), or it may divide the whole uterus and cervix, forming two cavities, or the septum may extend to the internal 044 only (uterus septus unicollis).
Symptoms and symp toms do not usually attract attention until puberty or marriage, when dysmen orrhwa, amenorrhoea, sterility, dyspa reunia, or the signs and symptoms of atresia of the vagina, with retention, develop.
The shape and size of the uterus is determined best by the bimanual recto abdominal examination. If the vagina and cervix be well developed, the cervix can be pulled down within better reach by a vulsellum, and the character of the interior of the uterus may also be de termined approximately by the sound.
If the diagnosis be difficult, it may be possible, with the aid of anmsthesia, to introduce a finger into the bladder; then the uterus, tubes, and ovaries can be pal pated between it and a finger of the other hand in the rectum. When the uterus is rudimentary, slightly resisting cords, representing the Fallopian tubes, can be felt, which are joined at the site of the uterus on the posterior surface of the bladder and lead outward to the rudi mentary ovaries, if such exist. If the uterus be one-horned, its fusiform shape can be palpated, extending laterally up ward, and also the rudimentary horn on the opposite side. The two-horned uterus is easily recognized by the depres sion in the fundus, and the double uterus by the presence of two elongated hard bodies merging together in the vagina below.
Treatment.—There is but little to do in the way of developing the organ or improving its shape. and irremediable symptoms may call for removal of the ovaries or uterus or both. Pregnancy in a rudimentary horn usually eventuates in rupture, and calls for a removal of the affected part.
• "After the complete union of Mueller's ducts the following deformities may result :— PCETALEnus.—The foetal character istics remain. The body is small and cylindrical, and may be solid. The cer vix measures about one inch, and twice as long as the uterus. The papillary folds of the cervix extend throughout the cavity.