OHVIRA syndrome: Early recognition prevents genitourinary complications

Anne Sijmons*, Suzanne Broekhuizen, Karin van der Tuuk, Martijn Verhagen, Martine Besouw

*Bijbehorende auteur voor dit werk

    OnderzoeksoutputAcademicpeer review

    1 Citaat (Scopus)

    Samenvatting

    Introduction: The obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is characterized by the triad uterus didelphys, obstructed hemivagina, and ipsilateral renal dysplasia. To make a radiological diagnosis, knowledge of this syndrome is of paramount importance. Early recognition may prevent complications such as unnecessary surgical procedures, endometriosis, and infections, which could adversely affect fertility.

    Case report: A 1-day-old female newborn in whom a right-sided cystic kidney abnormality was seen on antenatal ultrasound was admitted with anuria and intralabial mass. Besides the multicystic dysplastic right kidney, ultrasound revealed a uterus didelphys with right-sided uterus dysplasia, an obstructed right hemivagina, and an ectopic ureteric insertion. The diagnosis of obstructed hemivagina and ipsilateral renal anomaly syndrome with hydrocolpos was made and the hymen was incised. Later, ultrasound helped in diagnosing a pyelonephritis in the afunctional right kidney that was not draining into the bladder (hence no culture could be obtained), requiring intravenous antibiotics and a nephrectomy.

    Discussion: Obstructed hemivagina and ipsilateral renal anomaly syndrome is an anomaly of the Mullerian and Wolffian ducts of unknown cause. Patients typically present after menarche with (progressive) abdominal pain, dysmenorrhea, or urogenital malformations. In contrast, prepubertal patients can present with urinary incontinence or an (external) vaginal mass. The diagnosis is confirmed by an ultrasound or magnetic resonance imaging. Follow-up includes repeated ultrasounds and monitoring of kidney function. Treatment consists of drainage of the hydrocolpos/hematocolpos; in some cases, further surgery is indicated.

    Conclusion: Consider obstructed hemivagina and ipsilateral renal anomaly syndrome in girls with genitourinary abnormalities: early recognition prevents complications later in life.

    Originele taal-2English
    Pagina's (van-tot)61-64
    Aantal pagina's4
    TijdschriftUltrasound
    Volume31
    Nummer van het tijdschrift1
    Vroegere onlinedatum20-jun.-2022
    DOI's
    StatusPublished - feb.-2023

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