Korean J Obstet Gynecol.  2011 Dec;54(12):820-824. 10.5468/KJOG.2011.54.12.820.

An unusual presentation of obstructed hemivagina and ipsilateral renal anomaly syndrome: A case report

• Kim WO
• Park KE
• Ku SY
• Kim SH
• Choi YM
• Kim JG
• Moon SY

• KMID: 1443950
• DOI: http://doi.org/10.5468/KJOG.2011.54.12.820

Abstract

Most patients with syndrome of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) were presented with dysmenorrhea, pelvic mass and hematocolpos. These common symptoms of OHVIRA syndrome were aggravated soon after the menarche. Early diagnosis is important to relieve the symptom, to prevent injury of genital tract and to preserve fertility. We have experienced an unusual presentation of OHVIRA syndrome, which were presented with vaginal spotting and diagnosed at age 24. Therefore, we present it with a review of the literature.

Keyword

Uterus didelphys; Obstructed hemivagina; Renal agenesis; Mullerian anomalies

MeSH Terms

Congenital Abnormalities
Dysmenorrhea
Early Diagnosis
Female
Fertility
Hematocolpos
Humans
Kidney
Kidney Diseases
Menarche
Metrorrhagia
Congenital Abnormalities
Kidney
Kidney Diseases

Figure

• 

  Fig. 1 Transvaginal sonographic findings. (A) Uterine didelphys on coronal view. (B) Hematocolpos on sagittal view.

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  Fig. 2 The left upper vagina was dilated and filled with hematoma which was seen as high signal intensity on T2 weighted magnetic resonance imaging. This finding caused by vaginal atresia was consistent with hematocolpos. The annotated tubular structure arising from left upper side of affected vagina was presumed remnant left distal ureter opened to the vagina.

• 

  Fig. 3 The left upper vagina was dilated and filled with hematoma which was seen as high signal intensity on T2 weighted magnetic resonance imaging. This finding caused by vaginal atresia was consistent with hematocolpos. The annotated tubular structure arising from left upper side of affected vagina was presumed remnant left distal ureter opened to the vagina.

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  Fig. 4 Post-instillation images of saline infusion sonohysterography. (A) Endometrial cavity of right uterus was dilated normally. (B) But left side was not. There is no evidence of communication between both side of uterine cavity.

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  Fig. 5 Laparoscopic finding. There were normal ovaries and tubes arising from each side of uterine cornus. Left lower side of uterine posterior wall was hyperemic and bulged due to hematocolpos. There was a small endometriotic spot on the affected peritoneal surface.

Reference

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