Born with a double cervix, a double uterus, and a double vagina, she shares her ordeal.

Abigael Kendi, a 19-year-old Kenyan, agreed to speak with BBC journalist Asha Juma about the daily consequences of a rare congenital malformation: a complete didelphys uterus with double cervix, double vagina, and unilateral renal agenesis. To date, she has had seven surgeries aimed at restoring a menstrual cycle, without results. She is currently receiving treatment at the Kenyatta National Hospital in Nairobi.

The didelphys uterus results from a failure of the Müllerian ducts to fuse between the sixth and fourteenth weeks of embryonic life. In its complete form, it presents as two distinct uteri, each with its own cervix, and may be accompanied by a longitudinal vaginal septum creating two separate vaginal canals. According to medical literature, the condition affects approximately one in 3,000 women. The association with unilateral renal agenesis, the absence of one kidney, is documented in literature as a known comorbidity of Müllerian duct anomalies: both embryonic structures, the genital tract and kidney, develop from the same precursors.

Abigael’s condition was only diagnosed in adolescence, after an emergency admission due to severe abdominal swelling and an inability to urinate normally. A scan simultaneously revealed the two uteri, two cervixes, two vaginas, and the absence of one kidney. The remaining kidney shows fluid retention, exposing her to a risk of urinary stones and requiring continuous medication.

Seven surgeries, no results

The absence of functional menstrual drainage is one of the most burdensome clinical manifestations of Abigael’s case. She states that she has never had a period but experiences intense pain twice a month following a regular cycle, corresponding to the accumulation of blood in the uterine cavities that cannot be evacuated normally. During these episodes, medical interventions are necessary to relieve the pressure.

The management of urinary functions poses a second major daily constraint. With her bladder being distended, she has been using a urinary catheter for several years, including during her schooling. She learned to insert it herself after doctors noted the recurrence of infections related to repeated catheterization.

Abigael has undergone seven surgeries aimed at correcting structural anomalies and restoring menstrual flow. None have resulted in this outcome. She has also developed a fluid buildup inside her skull, discovered during a later scan, which could not be operated on due to the risk it posed to her single, already weakened kidney.

She speaks of profound fatigue in the face of a lack of therapeutic prospects and describes feeling like a financial burden to her parents, who have sold part of their belongings to fund her care. She has gone through intense episodes of despair, while attributing her strength to her family. She has channeled her experience into writing and says she wants to become a doctor.

Social stigmatization

Abigael describes facing cultural and spiritual interpretations of her condition within her community, presumed witchcraft, hereditary curse, as well as a lack of understanding at school, where her use of private toilets due to her medical constraints drew reactions from peers and teachers who were unaware of the reasons for this arrangement.

She indicates that neither she nor her parents initially made public the details of her condition, particularly the existence of her two genital tracts, which left the community to speculate. Her decision to speak publicly with the BBC comes in this context.

Her testimony highlights the difficulty of accessing early diagnosis and specialized care in a context where local medical teams may not necessarily have experience with such rare anomalies. The Kenyatta National Hospital, where she is currently being treated, is the public reference institution in Kenya.