{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T01:24:34Z","timestamp":1771550674081,"version":"3.50.1"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T00:00:00Z","timestamp":1681171200000},"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. Surg."],"abstract":"<jats:p>Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome is a rare congenital defect of the Mullerian ducts characterized by uterine didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. It frequently presents during puberty, with complications such as pelvic pain, pelvic inflammatory disease and infertility. Surgical management is the mainstay treatment. A vaginal access for septum resection is usually used. However, it can be in difficult in several situations such as a very proximal septum with a small bulge, or in the case of virgin patients with social considerations regarding the hymenal ring integrity. Thus, a laparoscopic approach may be a beneficial alternative. In particular, laparoscopic hemi hysterectomy has recently gained remarkable interest due to its added benefit of treating the cause rather than treating only the symptoms. It removes the source of the bleeding, thus stopping the flow. However, it transforms a bicornuate uterus into a unicornuate uterus, leading to some obstetrical concerns. Should we push the frontiers further and consider laparoscopic hemi hysterectomy for better outcomes as the mainstay management of patients with OHVIRA syndrome?<\/jats:p>","DOI":"10.3389\/fsurg.2023.1158753","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T06:00:23Z","timestamp":1681192823000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Reconsidering the best minimally invasive approach for patients with herlyn-werner-wunderlich syndrome: Should we push the frontiers for a better outcome?"],"prefix":"10.3389","volume":"10","author":[{"given":"Graziella","family":"Moufawad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amal","family":"Ayed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaki","family":"Sleiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1093\/humrep\/det098","article-title":"The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies","volume":"28","author":"Grimbizis","year":"2013","journal-title":"Hum Reprod"},{"key":"B2","first-page":"167","article-title":"Uncommon presentations of an uncommon entity: oHVIRA syndrome with hematosalpinx and pyocolpos","volume":"9","author":"Sleiman","year":"2017","journal-title":"Facts Views Vis Obgyn"},{"key":"B3","doi-asserted-by":"publisher","first-page":"653 e651","DOI":"10.1016\/j.jpurol.2021.06.023","article-title":"Multiple variants of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome\u2014one clinical center case series and the systematic review of 734 cases","volume":"17","author":"Kudela","year":"2021","journal-title":"J Pediatr Urol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.jpurol.2018.01.011","article-title":"Screening for mullerian anomalies in patients with unilateral renal agenesis: leveraging early detection to prevent complications","volume":"14","author":"Friedman","year":"2018","journal-title":"J Pediatr Urol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.jpag.2014.09.008","article-title":"Obstructed hemivagina with ipsilateral renal anomaly","volume":"29","author":"Santos","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/j.tjog.2020.01.003","article-title":"Diagnosis and treatment of m\u00fcllerian malformations","volume":"59","author":"Pinto","year":"2020","journal-title":"Taiwan J Obstet Gynecol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"33","DOI":"10.23736\/S0026-4806.19.06341-9","article-title":"Uterine anomalies and endometriosis","volume":"111","author":"Freytag","year":"2020","journal-title":"Minerva Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.ijgo.2012.11.023","article-title":"Clinical characteristics of 70 patients with herlyn\u2013werner\u2013wunderlich syndrome","volume":"121","author":"Tong","year":"2013","journal-title":"Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet"},{"key":"B9","doi-asserted-by":"crossref","first-page":"217","DOI":"10.29252\/ijrm.14.3.217","article-title":"Mini-laparotomic colpotomy for a cervicovaginal leiomyoma: preservation of hymenal integrity","volume":"14","author":"Yal\u00e7in","year":"2016","journal-title":"Int J Reprod Biomed"},{"key":"B10","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1089\/lap.2018.0592","article-title":"A novel surgical intervention for an uncommon entity: laparoscopy-assisted resection of a vaginal septum in obstructed hemivagina and ipsilateral renal anomaly syndrome","volume":"29","author":"Sleiman","year":"2019","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"B11","doi-asserted-by":"publisher","first-page":"303","DOI":"10.4274\/jtgga.galenos.2019.2019.0046","article-title":"Herlyn-Werner-Wunderlich syndrome; laparoscopic treatment of obstructing longitudinal vaginal septum in patients with hematocolpos\u2014a different technique for virgin patients","volume":"21","author":"Boyraz","year":"2020","journal-title":"J Turk Ger Gynecol Assoc"},{"key":"B12","doi-asserted-by":"publisher","first-page":"208","DOI":"10.4274\/tjod.23434","article-title":"True management of obstructed hemi-vagina and ipsilateral renal anomaly syndrome","volume":"13","author":"Yakistiran","year":"2016","journal-title":"Turk J Obstet Gynecol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.fertnstert.2019.04.016","article-title":"A case of obstructed hemivagina and ipsilateral renal anomaly syndrome complicated with pyometra: tips and tricks for laparoscopic hemihysterectomy","volume":"112","author":"Huseyin","year":"2019","journal-title":"Fertil Steril"},{"key":"B14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.clinimag.2019.11.013","article-title":"Diagnosis, management, and outcome of obstructed hemivagina and ipsilateral renal agenesis (OHVIRA syndrome): is there a correlation between MRI findings and outcome?","volume":"59","author":"Gungor Ugurlucan","year":"2020","journal-title":"Clin Imaging"},{"key":"B15","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1002\/uog.10056","article-title":"Reproductive outcomes in women with congenital uterine anomalies: a systematic review","volume":"38","author":"Chan","year":"2011","journal-title":"Ultrasound in Obstetrics and Gynecol"},{"key":"B16","first-page":"233","article-title":"Obstetric outcome in women with congenital uterine malformations","volume":"37","author":"Golan","year":"1992","journal-title":"J Reprod Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/S0029-7844(97)83836-7","article-title":"Double uterus, blind hemivagina, and ipsilateral renal agenesis: 36 cases and long-term follow-up","volume":"90","author":"Candiani","year":"1997","journal-title":"Obstet Gynecol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1158753\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,10]],"date-time":"2023-12-10T12:57:55Z","timestamp":1702213075000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2023.1158753\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,11]]},"references-count":17,"alternative-id":["10.3389\/fsurg.2023.1158753"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2023.1158753","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,11]]},"article-number":"1158753"}}