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Moufawad G, Giannini A, D’Oria O, Laganà AS, Chiantera V, Khazzaka A, Maziad G, Nasr E, Geagea V, Jardali MA, Sleiman Z. Obstructed Hemivagina and Ipsilateral Renal Anomaly Syndrome: A Systematic Review about Diagnosis and Surgical Management. Gynecol Minim Invasive Ther 2023; 12:123-129. [PMID: 37807996 PMCID: PMC10553600 DOI: 10.4103/gmit.gmit_103_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/03/2022] [Accepted: 11/15/2022] [Indexed: 10/10/2023] Open
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.
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Affiliation(s)
- Graziella Moufawad
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Andrea Giannini
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Ottavia D’Oria
- Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS “Civico – Di Cristina – Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS “Civico – Di Cristina – Benfratelli”, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Aline Khazzaka
- Department of Obstetrics and Gynaecology, Laboratory of Science and Research, Saint Joseph University, Beirut, Lebanon
| | - Ghida Maziad
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Elena Nasr
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Vanessa Geagea
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Marwa Al Jardali
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
| | - Zaki Sleiman
- Department of Obstetrics and Gynaecology, School of Medicine, Lebanese American University, Beirut, Lebanon
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Egbe TO, Kobenge FM, Wankie EM. Virginity-sparing management of hematocolpos with imperforate hymen: case report and literature review. SAGE Open Med Case Rep 2019; 7:2050313X19846765. [PMID: 31105948 PMCID: PMC6501474 DOI: 10.1177/2050313x19846765] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/03/2019] [Indexed: 11/21/2022] Open
Abstract
Imperforate hymen results from failure of the endoderm of the urogenital sinus to completely canalize and has an incidence of 0.01% to 0.05%. This sometimes presents as a pelvic mass that compresses the bladder causing acute urinary retention. A 13-year-old girl was referred to our department with a history of primary amenorrhea, cyclic lower abdominal pain, abdominal–pelvic mass, constipation and acute urinary retention. She had an ultrasonography misdiagnosis of a huge ovarian mass before referral to our unit. On examination, the vagina was bulging and compressing the rectum. Repeat abdominal ultrasonography confirmed the diagnosis of hematometrocolpos. She underwent X-shaped hymenotomy with a favorable outcome. Diagnosis of imperforate hymen requires high suspicion index. Virginity-sparing surgery constitutes a good treatment option for cultural and religious reasons.
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