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Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome.
J Obstet Gynaecol India 2019; 69(4):350-355JO

Abstract

Background

Herlyn-Werner-Wunderlich syndrome is an uncommon entity characterized by uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis (also called OHVIRA syndrome). Due to rarity and varied presentations, often correct diagnosis is missed out during work up, leading to management problems. We describe our dependence on detailed preoperative work up and minimally invasive endoscopic approach in management of the eight patients of OHVIRA syndrome.

Methods

In this retrospective case series study, eight patients of OHVIRA syndrome were managed from January 2012 to March 2018 with the help of improved imaging facility and diagnostic work up. Precise diagnosis helped in adopting minimally invasive approach in management. Patients were reviewed, focusing on presentation, radiologic findings and surgical management.

Results

Median age at diagnosis was 19 years (range 13-41 years). Abdominal pain and dysmenorrhea were the main presenting complaint. All patients except one had associated ipsilateral renal agenesis. Surgical excision of the obstructed hemivaginal septum and hematometra drainage was the main treatment. In seven patients, vaginoscopic resection of vaginal septum was done with resectoscope except one 41-year-old patient, where resection of vaginal septum was performed laparoscopically along with hysterectomy.

Conclusion

Vaginoscopic resection of obstructed hemivaginal septum is an effective method. Management has shifted to minimally invasive approach due to improved imaging, precise preoperative diagnosis and proper understanding of the disease.

Authors+Show Affiliations

1Paras Hospital, Gurgaon, India.Mahendru Hospital, New Delhi, India.3Obstetrics and Gynaecology Department, AIIMS, New Delhi, India.3Obstetrics and Gynaecology Department, AIIMS, New Delhi, India.3Obstetrics and Gynaecology Department, AIIMS, New Delhi, India.3Obstetrics and Gynaecology Department, AIIMS, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31391743

Citation

Kriplani, Alka, et al. "Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome." Journal of Obstetrics and Gynaecology of India, vol. 69, no. 4, 2019, pp. 350-355.
Kriplani A, Dalal V, Kachhawa G, et al. Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome. J Obstet Gynaecol India. 2019;69(4):350-355.
Kriplani, A., Dalal, V., Kachhawa, G., Mahey, R., Yadav, V., & Kriplani, I. (2019). Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome. Journal of Obstetrics and Gynaecology of India, 69(4), pp. 350-355. doi:10.1007/s13224-019-01240-4.
Kriplani A, et al. Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome. J Obstet Gynaecol India. 2019;69(4):350-355. PubMed PMID: 31391743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome. AU - Kriplani,Alka, AU - Dalal,Venus, AU - Kachhawa,Garima, AU - Mahey,Reeta, AU - Yadav,Vikas, AU - Kriplani,Isha, Y1 - 2019/06/10/ PY - 2018/12/06/received PY - 2019/05/12/accepted PY - 2020/08/01/pmc-release PY - 2019/8/9/entrez PY - 2019/8/9/pubmed PY - 2019/8/9/medline KW - Hematometra KW - Laparoscopy KW - Minimally invasive KW - OHVIRA syndrome KW - Vaginoscopy SP - 350 EP - 355 JF - Journal of obstetrics and gynaecology of India JO - J Obstet Gynaecol India VL - 69 IS - 4 N2 - Background: Herlyn-Werner-Wunderlich syndrome is an uncommon entity characterized by uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis (also called OHVIRA syndrome). Due to rarity and varied presentations, often correct diagnosis is missed out during work up, leading to management problems. We describe our dependence on detailed preoperative work up and minimally invasive endoscopic approach in management of the eight patients of OHVIRA syndrome. Methods: In this retrospective case series study, eight patients of OHVIRA syndrome were managed from January 2012 to March 2018 with the help of improved imaging facility and diagnostic work up. Precise diagnosis helped in adopting minimally invasive approach in management. Patients were reviewed, focusing on presentation, radiologic findings and surgical management. Results: Median age at diagnosis was 19 years (range 13-41 years). Abdominal pain and dysmenorrhea were the main presenting complaint. All patients except one had associated ipsilateral renal agenesis. Surgical excision of the obstructed hemivaginal septum and hematometra drainage was the main treatment. In seven patients, vaginoscopic resection of vaginal septum was done with resectoscope except one 41-year-old patient, where resection of vaginal septum was performed laparoscopically along with hysterectomy. Conclusion: Vaginoscopic resection of obstructed hemivaginal septum is an effective method. Management has shifted to minimally invasive approach due to improved imaging, precise preoperative diagnosis and proper understanding of the disease. SN - 0971-9202 UR - https://www.unboundmedicine.com/medline/citation/31391743/Minimally_Invasive_Endoscopic_Approach_for_Management_of_OHVIRA_Syndrome DB - PRIME DP - Unbound Medicine ER -