Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management

Abstract

Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome is a rare congenital defect of the Müllerian ducts characterized by uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. The aim of this systematic review is to summarize the main symptoms and presentation of the OHVIRA syndrome, as well as the different types of management, fertility, and obstetrical outcomes. A comprehensive search was performed in PubMed, EMBASE, SCOPUS, and Web of Science databases since inception to May 1, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. After duplicate records removed, the search strategy retrieved 103 articles. The full texts of 73 articles further were assessed for eligibility, and 44 studies were finally included in the systematic review. The mainstay surgical treatment of OHVIRA syndrome is usually a minimally invasive vaginal approach to remove the septum. Ultrasound-guided hysteroscopic resection and laparoscopic resection of the septum have been described as alternatives. Considering the feasibility of minimally invasive approach for the management of the syndrome, laparotomy should be avoided as much as possible and considered only in selected cases.

A rare cause of amenorrhea: Hematocolpos in a post‐cystocele repair patient

“…10 Another new method is virginity-sparing surgery which may be a better option for young ladies, especially in a conservative society as in Sudan. 11,12 Hysterectomy is considered a last option if the symptom-relieving methods have failed or on the patient's request. 13 The patients also had a correction of the uterus position due to the displacement of the uterus.…”

Satisfactory Outcome of Various Novel Modified Laparoscopic Neovaginoplasty Using Autologous Peritoneal Graft

“…Due to the close relationship between the development of urinary and reproductive systems, female patients with reproductive structural anomalies may benefit from evaluation later in life for renal malformations and vice versa. [ 11 ]…”

The Need for Earlier Diagnosis of Obstructed Hemivagina and Ipsilateral Renal Agenesis/Anomaly (OHVIRA) Syndrome in Case of Renal Agenesis in Girls—Case Report and Review of the Literature

“…There are no clear recommendations for the optimal time and method of surgical treatment for all patients. However, most published papers refer to the most minimally invasive option of vaginal septum resection [22][23][24][25]. A delay in proper diagnosis is not uncommon and has been reported by different authors [19,24].…”

“…However, most published papers refer to the most minimally invasive option of vaginal septum resection [22][23][24][25]. A delay in proper diagnosis is not uncommon and has been reported by different authors [19,24].…”