Hysteroscopic resection of vaginal septum under ultrasound guidance in ohvira syndrome with preservation of hymen

 Background/Aims:  To report a patient who had hysteroscopic vaginal septum removal in Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) syndrome, with preservation of the hymen under ultra sound guidance.

Methods: In a tertiary a cademic referral center, hysteroscopic vaginal septum resection was performed for a 12 year-old girl with  uterus didelphys, obstructed hemivagina, and renal agenesis along with hypothyroidism. Hysteroscopic resection of a vaginal septum in a single adolescent female, who had uterus didelphys and obstructed hemivagina that was preformed twice.

Results: Hematometrocolpos drainage after hysteroscopic resection of vaginal septum under ultrasound guidance, along with preservation of the hymen, is a more conservative alternative to conventional vaginal septum excision. This resulted in sympt omatic relief of the cyclic dysmenorrhea .after 4 months follow up. However, repeat surgery was necessary after 7 months due to closure of the vaginal septum incision.

Conclusion: Hysteroscopy is a safe alternative in resecting a vaginal septum in OHVIRA syndrome. However, repeat surgery might be indicated in few cases when the vaginal septum is high and thick. Longer follow up is warranted in such cases due to the risk of closure of the vaginal aperture along with the unintended consequences of hematometrocolpos and abdominal pain.