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Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated with Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA).

Abstract

STUDY OBJECTIVE

To propose a "3O" (obstruction, ureteric orifice, and outcome) subclassification system associated with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA).

DESIGN

Retrospective case series.

SETTING

Xiangya Hospital, Central South University, Changsha, Hunan, China.

PARTICIPANTS

A total of 26 women with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) over a 9-year period.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

In all cases, the obstruction, ureteric orifice, outcome and surgical strategy were reviewed.

RESULTS

In our study, the "obstruction" category included 14 cases of blind hemivagina, 8 cases of buttonhole septum, 3 cases of cervical fistula, and 1 case of cervical atresia. A total of 25 patients with vaginal obstruction underwent resection of the vaginal septum. The patient with cervical atresia underwent a failed cervicoplasty, followed by hemi-hysterectomy. The "ureteric orifice" category included 24 cases of absent ureter with no orifice, as well as 2 cases of ureteric orifice emptying into the obstructed hemivagina. The 2 patients were treated with laparoscopic extirpation of the ectopic ureter and renal moiety. Regarding the "outcome" category, 5 patients with severe recurrent hematometra, hematosalpinx, and ovarian endometrioma underwent hemi-hysterectomy, salpingectomy, and cystectomy of the ovarian endometrioma. Both patients (1 with a septate uterus and 1 with a bicornuate uterus) who experienced recurrent abortion accepted uterine correction.

CONCLUSION

We provide new insights into the anatomical variants of this rare syndrome with the relevant surgical implications. Magnetic resonance imaging is the most useful tool in 3O diagnosis.

Authors+Show Affiliations

Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.Department of Gynecologic Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medical, Central South University, Changsha, Hunan, China.Department of Urology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: wanglong@csu.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31931122

Citation

Zhang, Junjie, et al. "Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated With Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA)." Journal of Pediatric and Adolescent Gynecology, 2020.
Zhang J, Zhang M, Zhang Y, et al. Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated with Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA). J Pediatr Adolesc Gynecol. 2020.
Zhang, J., Zhang, M., Zhang, Y., Liu, H., Yuan, P., Peng, X., ... Wang, L. (2020). Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated with Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA). Journal of Pediatric and Adolescent Gynecology, doi:10.1016/j.jpag.2020.01.001.
Zhang J, et al. Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated With Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA). J Pediatr Adolesc Gynecol. 2020 Jan 10; PubMed PMID: 31931122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Proposal of the 3O (Obstruction, Ureteric Orifice, and Outcome) Subclassification System Associated with Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA). AU - Zhang,Junjie, AU - Zhang,Mengda, AU - Zhang,Yu, AU - Liu,Huining, AU - Yuan,Peng, AU - Peng,Xiaoyan, AU - Cao,Zhenzhen, AU - Wang,Long, Y1 - 2020/01/10/ PY - 2019/04/16/received PY - 2019/12/31/revised PY - 2020/01/02/accepted PY - 2020/1/14/pubmed PY - 2020/1/14/medline PY - 2020/1/14/entrez KW - 3O subclassification system KW - OHVIRA KW - Obstruction KW - Outcome KW - Ureteric orifice JF - Journal of pediatric and adolescent gynecology JO - J Pediatr Adolesc Gynecol N2 - STUDY OBJECTIVE: To propose a "3O" (obstruction, ureteric orifice, and outcome) subclassification system associated with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA). DESIGN: Retrospective case series. SETTING: Xiangya Hospital, Central South University, Changsha, Hunan, China. PARTICIPANTS: A total of 26 women with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) over a 9-year period. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: In all cases, the obstruction, ureteric orifice, outcome and surgical strategy were reviewed. RESULTS: In our study, the "obstruction" category included 14 cases of blind hemivagina, 8 cases of buttonhole septum, 3 cases of cervical fistula, and 1 case of cervical atresia. A total of 25 patients with vaginal obstruction underwent resection of the vaginal septum. The patient with cervical atresia underwent a failed cervicoplasty, followed by hemi-hysterectomy. The "ureteric orifice" category included 24 cases of absent ureter with no orifice, as well as 2 cases of ureteric orifice emptying into the obstructed hemivagina. The 2 patients were treated with laparoscopic extirpation of the ectopic ureter and renal moiety. Regarding the "outcome" category, 5 patients with severe recurrent hematometra, hematosalpinx, and ovarian endometrioma underwent hemi-hysterectomy, salpingectomy, and cystectomy of the ovarian endometrioma. Both patients (1 with a septate uterus and 1 with a bicornuate uterus) who experienced recurrent abortion accepted uterine correction. CONCLUSION: We provide new insights into the anatomical variants of this rare syndrome with the relevant surgical implications. Magnetic resonance imaging is the most useful tool in 3O diagnosis. SN - 1873-4332 UR - https://www.unboundmedicine.com/medline/citation/31931122/Proposal_of_the_3O_(Obstruction,_Ureteric_Orifice,_and_Outcome)_Subclassification_System_Associated_with_Obstructed_Hemivagina_and_Ipsilateral_Renal_Anomaly_(OHVIRA) L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-3188(20)30002-4 DB - PRIME DP - Unbound Medicine ER -