{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:46:19Z","timestamp":1782301579015,"version":"3.54.5"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>OHVIRA syndrome is a rare M\u00fcllerian duct anomaly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Although typically diagnosed in adolescence, it can rarely present later in life. We present the case of a 49-year-old woman who presented with severe dysmenorrhea and intermittent spotting. Imaging studies, particularly MRI, confirmed the diagnosis of OHVIRA syndrome by revealing a didelphic uterus with hematometra and hematocolpos secondary to a right-sided obstructed hemivagina, along with right renal agenesis. The patient was successfully managed with vaginoscopic and hysteroscopic resection of the vaginal septum. Postoperatively, her symptoms resolved completely, with no recurrence observed at 6-month follow-up. This case contributes to the literature by documenting one of the latest known presentations of OHVIRA syndrome, reinforcing that a high index of suspicion for M\u00fcllerian anomalies must be maintained regardless of patient age. It demonstrates that a partially draining orifice can mask classic symptoms for decades and confirms the long-term efficacy of a minimally invasive surgical approach for both diagnosis and treatment.<\/jats:p>","DOI":"10.3389\/fmed.2026.1769370","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:02:23Z","timestamp":1772002943000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Late-onset OHVIRA syndrome in a 49-year-old woman with severe dysmenorrhea: a case report on vaginoscopic management"],"prefix":"10.3389","volume":"13","author":[{"given":"Yusuf Ziya","family":"Kizildemir","sequence":"first","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, Harran University","place":["Sanliurfa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6mer","family":"Tammo","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, Harran University","place":["Sanliurfa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"\u0130ncebiyik","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, Harran University","place":["Sanliurfa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Erdal","family":"Sak","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, Harran University","place":["Sanliurfa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibel","family":"Sak","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics, Faculty of Medicine, Harran University","place":["Sanliurfa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1016\/j.jpag.2023.07.008","article-title":"Pregnancy outcomes in patients with obstructed hemivagina ipsilateral renal agenesis","volume":"36","author":"Erkkinen","year":"2023","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1002\/ijgo.70164","article-title":"Clinical features and surgical options of obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome: a systematic review and a meta-analysis of prevalence","volume":"171","author":"Bonetti","year":"2025","journal-title":"Int J Gynaecol Obstet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/j.jpag.2023.07.002","article-title":"Obstructed hemivagina ipsilateral renal agenesis (OHVIRA) syndrome-a retrospective cohort analysis of the Sabah population","volume":"36","author":"Lim","year":"2023","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e79","DOI":"10.1016\/j.jpag.2013.07.009","article-title":"Delayed diagnosis of Herlyn-Werner-Wunderlich syndrome due to microperforation and pyocolpos in obstructed vaginal canal","volume":"27","author":"Wozniakowska","year":"2014","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"128","DOI":"10.4103\/jhrs.jhrs_19_24","article-title":"Magnetic resonance imaging evaluation of Wolffian duct anomalies - OHVIRA and OSVIRA","volume":"17","author":"Bansal","year":"2024","journal-title":"J Hum Reprod Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"100060","DOI":"10.1016\/j.jeud.2024.100060","article-title":"Magnetic resonance imaging for proper diagnosis and management of M\u00fcllerian duct anomalies","volume":"6","author":"Vitale","year":"2024","journal-title":"J Endometr Uterine Disord"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1007\/s00404-025-08170-9","article-title":"Misdiagnosis in patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: a retrospective study of 164 cases","volume":"312","author":"Song","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S70","DOI":"10.1016\/j.jmig.2024.09.713","article-title":"11172 Ohvira & Surgical management","volume":"31","author":"Garcia","year":"2024","journal-title":"J Minim Invasive Gynecol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1007\/s13669-025-00441-1","article-title":"OHVIRA: an in-depth review with practical applications for OBGYNs worldwide","volume":"14","author":"Moon","year":"2025","journal-title":"Curr Obstet Gynecol Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e26","DOI":"10.1055\/a-2208-0032","article-title":"Case series of reproductive outcomes after surgical correction of obstructed Hemivagina in OHVIRA","volume":"14","author":"Bunnell","year":"2024","journal-title":"AJP Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"10571","DOI":"10.3390\/ijerph191710571","article-title":"The impact of uterus Didelphys on fertility and pregnancy","volume":"19","author":"\u0106wiertnia","year":"2022","journal-title":"Int J Environ Res Public Health"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1769370\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T07:02:23Z","timestamp":1772002943000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1769370\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":11,"alternative-id":["10.3389\/fmed.2026.1769370"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1769370","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"1769370"}}