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RCOG World Congress 2023
June 12 - 14, 2023 | London, UK
EP.0298
OHVIRA presenting with intermittent urinary tract obstruction
Poster Presenter
Authors
Affiliations
Part of Topic
Adolescent Gynaecology
Obstructed Hemi-Vagina and Ipsilateral Renal Agenesis (OHVIRA)
•A 14 years old girl with difficulty in emptying bladder intermittently for over a year along with urinary hesitancy, unassociated with menstruation.
• Dysmenorrhea beginning a day before every cycle, lasting for a day or two.
•Rest of the history, general physical and abdominal examination unremarkable.
• Vulva normal and digital examination revealed a soft bulge on right side in vagina.
•Baseline workup including CBC, UCE, UDR and UCS were normal.
MANAGEMENT :
Resection of vaginal septum with cystoscopy and vaginoscopy
•Around 50 ml clotted blood drained
•Septum was resected, edges marsupialized
•Twenty-four gauge foleys tamponade inserted and vagina packed with gel gauze which was removed the next day.
•Recovery uneventful.
•Post operative follow-up after a month unremarkable.
•6 months later, she came to clinic with urinary hesitancy but regular cycles. Ultrasound was normal with nil post residual volume hence patient reassured.
•One year follow-up in clinic unremarkable and she had regular cycles.
TAKE HOME
•OHVIRA has a variety of clinical presentations thus can be missed easily.
•Recurrent urinary symptoms in a young adolescent female should elicit a high suspicion of OHVIRA.
•MRI is the gold standard investigation.
•Surgical correction at its earliest should be performed to relieve the symptoms and prevent long term complications.