Ultrasound diagnosis and clinical analysis of obstructed hemivagina and ipsilateral renal anomaly syndrome

doi:10.3877/cma.j.issn.1672-6448.2024.09.006

Abstract

Abstract:

Objective

To investigate the clinical features of obstructed hemivagina and ipsilateral renal anomaly （OHVIRA） syndrome and analyze the value of ultrasonography in the diagnosis of this condition.

Methods

From January 2013 to June 2022， 32 cases of OHVIRA syndrome diagnosed and surgically treated at Maternal and Child Health Hospital of Hubei Province were retrospectively analyzed.

Results

Oblique septum occurred on the left side in 14 cases and on the right side in 18. Twenty-two cases underwent oblique vaginal septum resection， and ten underwent combined hysteroscopic and laparoscopic oblique septum resection. Four cases underwent unilateral hysterectomy due to cervical atresia or dysplasia，and two underwent nephroureterectomy due to pelvic renal ectopia with dysplasia and ectopic ureteral orifice.With regard to reproductive system involvement， there were 22 cases of duplex uterus， 7 cases of complete septate uterus， and 3 cases of bicornuate uterus； there were 2 cases of cervical atresia and 8 cases of cervical dysplasia； there were 30 cases of hematocolpos， 21 cases of hematometra， 17 cases of hematosalpinx， 2 cases of pyosalpinx， 5 cases of hemoperitoneum， and 10 cases of pelvic adhesion. Regarding urinary system involvement， all 32 cases were complicated with abnormal development of the urinary system. One of the kidneys was absent in 29 cases， and there was one case of renal cystic dysplasia and two cases of pelvic renal ectopia and renal dysplasia with ectopic ureteral orifice. Among the 32 cases of OHVIRA syndrome， there were 14 cases of type I， 9 cases of type II， 7 cases of type III， and 2 cases of type Ⅳ. Ultrasonography can accurately diagnose uterine malformation， hematocolpos， hematometra， hemoperitoneum， and renal dysplasia.

Conclusion

Ultrasonography is the preferred and reliable method for diagnosing OHVIRA syndrome.

Key words: Ultrasonography, Uterovaginal anomaly, OHVIRA syndrome

Yanjuan Bao, Xiaohong Yang, Tao Zhang, Sheng Zhao, Li Zhang. Ultrasound diagnosis and clinical analysis of obstructed hemivagina and ipsilateral renal anomaly syndrome[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(09): 859-864.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2024.09.006

https://chaosheng.cma-cmc.com.cn/EN/Y2024/V21/I09/859

Figures/Tables 5

References 12

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分型	例数	发病年龄（岁）	初潮至发病时间（年）
Ⅰ型	14	17.36±4.67^a	5.29±4.23^a
Ⅱ型	9	24.89±6.85	11.83±6.33
Ⅲ型	7	20.14±5.08	7.43±4.89
Ⅳ型	2	21.50（10.50，23.50）	9.00（1.50，13.75）

分型	例数	发病年龄（岁）	初潮至发病时间（年）
Ⅰ型	14	17.36±4.67^a	5.29±4.23^a
Ⅱ型	9	24.89±6.85	11.83±6.33
Ⅲ型	7	20.14±5.08	7.43±4.89
Ⅳ型	2	21.50（10.50，23.50）	9.00（1.50，13.75）

分型	例数	无痛经	轻度痛经	重度痛经	经期淋漓不尽或不规则出血	阴道排液和阴道炎	尿路感染
Ⅰ型	14	1	5	8	4	0	0
Ⅱ型	9	8	1	0	9	2	1
Ⅲ型	7	2	4	1	6	2	1
Ⅳ型	2	1	1	0	0	0	0

分型	例数	无痛经	轻度痛经	重度痛经	经期淋漓不尽或不规则出血	阴道排液和阴道炎	尿路感染
Ⅰ型	14	1	5	8	4	0	0
Ⅱ型	9	8	1	0	9	2	1
Ⅲ型	7	2	4	1	6	2	1
Ⅳ型	2	1	1	0	0	0	0

生殖系统畸形	手术及病理	超声诊断
双子宫	22	22
完全纵隔子宫	7	7
双角子宫	3	3
斜隔侧宫颈闭锁	2	1
斜隔侧宫颈发育不良	8	2
隔后腔积液	30	30
斜隔侧宫腔积液	21	21
斜隔侧输卵管积血	17	15
斜隔侧输卵管积脓	2	0
卵巢巧克力样囊肿	5	3
盆腔粘连	10	3

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