The Obstructed Hemivagina, Ipsilateral Renal Anomaly, and Uterine Didelphys Triad and the Subsequent Manifestation of Cervical Aplasia

Sabdia, S.; Sutton, Bridget M.; Kimble, Roy M.

doi:10.1016/j.jpag.2014.02.001

Cited by 18 publications

(11 citation statements)

References 21 publications

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“…In our procedure the septum is incised by use of a hysteroscope, rather than excised as occurs during traditional surgery. Incision is preferred over excision as the latter may lead to scar formation and is more likely to be complicated by re-obstruction and vaginal stenosis 27 . The Foley catheter balloon placement between the incised vaginal septum is a novel technique that prevents future adhesions.…”

Section: Discussionmentioning

confidence: 99%

Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Cheng

Subedi

Zhang

et al. 2019

Sci Rep

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This study is to evaluate the efficacy and safety of vaginoscopic incision of oblique vaginal septum in adolescents with Obstructed hemi-vagina and ipsilateral renal agenesis (OHVIRA) syndrome. It is about Fourteen adolescents with OHVIRA syndrome managed by vaginoscopic incision of the oblique vaginal septum using a “No-touch” technique over an 8-year period. In all fourteen adolescents with OHVIRA the oblique vaginal septum was incised successfully without any intraoperative complications. Postoperative pain was unremarkable and each patient’s symptoms resolved postoperatively. The 3-month postoperative follow up office vaginoscopy revealed that the vaginal septum had not reformed nor was any vaginal stenosis noted. Vaginoscopic incision of the oblique vaginal septum using a “No-Touch” technique is a safe, minimally invasive, and effective approach for treating OHVIRA syndrome in adolescents with hematocolpos. This technique may be utilized to minimize disruption to the undeveloped vaginal wall and postoperative pain while providing excellent surgical visualization throughout the procedure.

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Section: Discussionmentioning

confidence: 99%

Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Cheng

Subedi

Zhang

et al. 2019

Sci Rep

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“…Preoperative diagnosis is difficult and in reported cases, the diagnosis is often made intraoperatively. 1,2,4,6,7,9 While MRI can assist with preoperative diagnosis and surgical planning, in multiple cases, the diagnosis of surgical atresia was missed 1,2,6,7,9,10 Cervical fistula formation carries a risk of severe infection 11 and it has been proposed that the amount of cervical tissue present should dictate whether or not fistula creation is attempted. 12 The alternative is hemihysterectomy.…”

Section: Use Of Interceedò Absorbable Adhesion Barrier In Pediatric Amentioning

confidence: 99%

Use of 3-D MRI to Diagnose Unilateral Cervical Atresia in Obstructive Hemivagina and Ipsilateral Renal Anomaly (OHVIRA)

Tomlin

Williamson

2017

Journal of Pediatric and Adolescent Gynecology

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monthly cycles lasting 5 days. MRI revealed UD with hematometrocolpos versus hematometra alone due to left-sided CA and left hematosalpinx. She was started on Lupron for menstrual suppression. Six months later she underwent vaginoscopy, cystoscopy, right ureteral stent insertion, roboticassisted laparoscopic excision of the left uterine horn and fallopian tube, lysis of adhesions, chromotubation, and cystectomy and drainage of endometriomas. Intraoperative findings included obstructed functional left uterine horn with CA, left hematosalpinx, normal right uterine horn and fallopian tube with rightward deviated vagina and cervix, right tubal patency, significant dense adhesions, and endometriosis. Postoperatively, she continues on Lupron therapy for endometriosis suppression. Case 2: A 15 year old female with known solitary right kidney presented to clinic for a second opinion of a MA. She had menarche at age 11 and developed severe dysmenorrhea. She was started on combined oral contraceptive pills by her pediatrician but dysmenorrhea continued. MRI showed UD with concern for hematometrocolpos versus hematometra due to left CA. She underwent surgery, including cystoscopy, right ureteral stent placement, vaginoscopy, robotic-assisted laparoscopic excision of left uterine horn and fallopian tube, and chromotubation. Intraoperative findings included normal single cervix and vagina, left uterine horn with CA, obstructed left dilated fallopian tube with filmy adhesions to left pelvic sidewall, normal right uterine horn and fallopian tube with confirmed tubal patency, and endometriosis. After surgery she was initiated on Lupron for endometriosis suppression.

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“…MRI may not be able to clearly diagnose specifi c subtle cervical architectural abnormalities or other rare variations of Müllerian duct development. Complex anomalies may require diagnostic laparoscopy to resolve diagnostic uncertainties [ 18 ]. Referral should be made to a tertiary care center with specifi c expertise in congenital anomalies of the reproductive tract for accurate diagnosis and appropriate surgical intervention [ 19 , 20 ].…”

Section: Amenorrhea and Pelvic Painmentioning

confidence: 99%

“…A cotton tipped applicator can be used to demonstrate a unilateral patent vagina. Rarely in individuals with OHVIRA the obstruction may be at the level of the cervix rather than vagina, but also associated with unilateral renal agenesis [ 18 ].…”

Section: Pelvic Pain Associated With Menstruationmentioning

confidence: 99%

Diagnostic Approach to Müllerian Anomalies

Appelbaum

Choi-Rosen

Tonick

2016

Congenital Müllerian Anomalies

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The Obstructed Hemivagina, Ipsilateral Renal Anomaly, and Uterine Didelphys Triad and the Subsequent Manifestation of Cervical Aplasia

Cited by 18 publications

References 21 publications

Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Use of 3-D MRI to Diagnose Unilateral Cervical Atresia in Obstructive Hemivagina and Ipsilateral Renal Anomaly (OHVIRA)

Diagnostic Approach to Müllerian Anomalies

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