In a tremendous surgical exercise, a medical team at Dr. Ram Manohar Lohia Institute of Medical Sciences (RMLIMS) has successfully managed to care for a 12-year-old girl born with a trio of very rare congenital anomalies. The case was of a Ballia District resident living with Uterus Didelphys and two uteruses, and another woman who developed many complications that had taken down the normal parts from her womb from the time of birth. A little girl had had her childhood plagued with frequent urinary leakage and an extreme lack of bowel function. Before arriving at RMLIMS, a detailed medical scan and endoscopic tests showed three major problems:
Uterus Didelphys:
Two complete uteruses and two separate vaginal canals. These are:
1. Ectopic Ureters: The tubes transporting urine from the kidneys were open in the wrong locations, causing an inability to regulate urination.
2. Anorectal Malformation: An underdeveloped and misplaced anal opening which prevented normal bowel movement.
“Those types of conditions [a combination of these are very rare and had never before been reported in that state previously," said Prof. Ishwar Ram Dhayal, Head of the Urology and Renal Transplant Department.
The Three-Stage Surgical Approach. A team led by Prof. Dhayal and Dr. Sarvagya Jain and Dr. Prithvi scheduled an extensive 3- phases management course over time, spanning months:
- Stage 1: Surgeons dealt with the large intestine to fix damage inflicted by years of internal pressure and chronic constipation.
- Stage 2: The team did reconstructive surgery for the opening with widened and new positions to aid bowel function.
- Stage 3: The last stage was with urinary tract, in which ectopic ureters were transferred to the bladder to eventually give the patient control over his or her own urine.
A New Lease on Life
The surgeries were 100% successful. For the first time in her life, the 12-year-old now lives without diapers and can take care of herself and carry out all activities of daily living without aid. Although she has two uteruses and vaginas, doctors have said that for the time being these do not require surgical removal and she will have a normal life thereafter.
Prof. CM Singh, Director of RMLIMS, lauded the team’s work, explaining that the case shows the institute’s increasing prowess at handling complicated pediatric urology cases. “It is a sign of how scheduled surgery and state of the art diagnostics can transform lives,” he said.
