Mullerian malformations: classification, diagnosis, and management strategies

Abstract

Objective: To analyze the main aspects related to Mullerian malformations, including etiopathogenesis, classification, diagnostic methods, and clinical and surgical approaches for their treatment. Literature review: Mullerian duct anomalies are more common congenital alterations than previously thought, with an estimated prevalence between 0.5% and 6.7% in the general population, reaching up to 16.7% among women with recurrent miscarriage. They originate during the development of the paramesonephric ducts due to fusion failure or lack of septum resorption after duct fusion. Key symptoms include primary amenorrhea, dysmenorrhea, pelvic pain, endometriosis, infertility, sexual dysfunction, and psychological impact such as low self-esteem. Given the significant physical and emotional repercussions, the relevance of this study is justified. Final considerations: Data indicating the best outcomes in the follow-up of these patients from diagnosis to treatment are presented. Self-dilation according to Frank's technique is the most recommended method for uterine and vaginal agenesis, though the best treatment remains controversial. In cases of menstrual flow obstruction, immediate surgical intervention is essential to prevent complications and preserve reproductive health and patient quality of life.