A walled uterus may sound like an uncommon uterine condition, but there are actually two main conditions that create a walled effect. These conditions are called septate uterus and didelphic uterus. Though the descriptions of these conditions may be similar, the two conditions are completely separate, medically.
A septate uterus occurs when a wall or uterine septum develops in the uterus. Thewall can extend to the vagina, essentially splitting it in two creating two vaginal openings. The septum splits ONE vagina, an important factor in the difference between the septate uterus and didelphic uterus. One cervix is present, but the cervix may be split by the septum.
A didelphic uterus can present similarly to the septate uterus, but there are actually two uterus and two vaginal openings. Each uterus is an independent organ, unlike the septate uterus that develops from a single uterus split in two. Two cervixes are present.
Confusion Between the Two Conditions
Not all cases of septate uterus and didelphic uterus cause double vaginal openings or double cervix development, so there is some confusion between the two conditions. Both develop at the same time in-utero – when the mullerian ducts are fusing and both carry an increased risk of infertility and spontaneous abortion.
In the cases of didelphic uterus, there are two completely formed uteruses of nearly full size. In the case of septate uterus, one uterus is split in two by the septum. This is the most recognizable difference between the two conditions.
If your doctor advises you of a wall in your uterus, further testing, including an ultrasound may be required to diagnose either septate or didelphic uterus. Many women with septate and didelphic uteruses have conceived and carried pregnancies to term. There are even cases of women carrying fetuses in both uteruses in patients with didelphic uterus.