Mabuchi Yasushi, Hirayama Junya, Ota Nami, Ino Kazuhiko
Department of Obstetrics and Gynecology, Wakayama Medical University, School of Medicine, Wakayama 641 0012, Japan.
Med Int (Lond). 2021 Oct 26;1(5):20. doi: 10.3892/mi.2021.20. eCollection 2021 Nov-Dec.
Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare Mullerian duct anomaly. Cases with pelvic inflammatory disease or endometriosis have been reported, which may influence fertility or the quality of life of patients; therefore, an accurate and early diagnosis is essential. The present study reports the case of patient (25-year-old female, gravida 0 para 0) with OHVIRA syndrome. Magnetic resonance imaging and a computed tomography scan revealed uterus didelphys and right renal agenesis. An opening was found on the vaginal septum during the menstrual period. Upon diagnostic vaginoscopy and hysteroscopy through the opening, the right vaginal cavity was enclosed, and the right uterine cervix and cavity were normal. The patient was diagnosed with OHVIRA syndrome. Her vaginal septum was surgically removed under direct visualization and the pathological findings of the resected septum revealed a benign squamous epithelium. The post-operative course was uneventful and restenosis of the vagina was not observed. On the whole, the present study demonstrates that the technique, diagnostic vaginoscopy and hysteroscopy, is minimally invasive and is sufficient for the diagnosis of incomplete vaginal obstruction-type OHVIRA syndrome.
梗阻性半阴道并同侧肾异常(OHVIRA)综合征是一种罕见的苗勒管异常。已有盆腔炎或子宫内膜异位症病例的报道,这可能会影响患者的生育能力或生活质量;因此,准确的早期诊断至关重要。本研究报告了一例患有OHVIRA综合征的患者(25岁女性,孕0产0)。磁共振成像和计算机断层扫描显示双子宫和右肾缺如。经期时在阴道隔上发现一个开口。通过该开口进行诊断性阴道镜检查和宫腔镜检查时,发现右侧阴道腔封闭,右侧子宫颈和宫腔正常。该患者被诊断为OHVIRA综合征。在直视下手术切除其阴道隔,切除隔的病理检查结果显示为良性鳞状上皮。术后过程顺利,未观察到阴道再狭窄。总体而言,本研究表明,诊断性阴道镜检查和宫腔镜检查技术微创,足以诊断不完全阴道梗阻型OHVIRA综合征。