{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:57:36Z","timestamp":1776272256874,"version":"3.50.1"},"reference-count":17,"publisher":"Galenos Yayinevi","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Facts Views Vis ObGyn"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>Background: Complete bicorporeal uterus, double cervix and obstructive longitudinal vaginal septum (classified as U3bC2V2 according to ESHRE\/ESGE classification) is a rare congenital anomaly of the genital tract. This condition is typically associated with ipsilateral renal agenesis and is known as Herlyn-Werner-Wunderlich syndrome or OHVIRA (Obstructed HemiVagina and Ipsilateral Renal Anomaly) syndrome. The primary symptoms include dysmenorrhea and pelvic pain, which usually manifest after menarche due to haematocolpos in the obstructed hemivagina. Diagnosis is often challenging and frequently delayed. Early detection and surgical drainage of the haematocolpos are essential for symptom relief and prevention of complications. Various surgical approaches have been described, with vaginoplasty and septal resection being the recommended treatment.\n\nObjective: To propose a step-by-step demonstration with narrated video footage of an integrated approach for one-stop diagnosis and ultrasound-guided endoscopic hymen-sparing treatment in a patient with OHVIRA syndrome.\n\nMaterials and Methods: We present the case of a 17-year-old virgo-intacta female who was referred to our institution due to dysmenorrhea, abnormal uterine bleeding and a right presumed ovarian endometrioma. A preoperative evaluation, including pelvic ultrasound and MRI, suspected a U3bC2V2 malformation, associated to a right haematocolpos and ipsilateral renal agenesis. The patient underwent a complete minimally invasive vaginoscopic resection of the obstructive longitudinal vaginal septum under transabdominal ultrasound guidance, using a 15Fr bipolar mini-resectoscope. The procedure successfully drained the haematocolpos and allowed visualisation of the right cervix, confirming the preoperative diagnosis.\n\nResults: The procedure was performed in our Digital Hysteroscopic Clinic (DHC) - CLASS Hysteroscopy -under general anaesthesia (with laryngeal mask), according to an ambulatory model of care. No complications occurred and the patient was discharged three hours after the procedure.\n\nMain outcomes: After 40 days, hysteroscopic office control revealed a normal vagina with double cervix and complete bicorporeal uterus (classified as U3bC2V0 according to ESHRE\/ESGE classification), and the patient had complete relief of symptoms.\n\nConclusion: The combined approach of one-stop diagnosis and ultrasound-guided minimally invasive vaginoscopic resection of the obstructive longitudinal vaginal septum, using a 15Fr bipolar mini-resectoscope, has proven to be an effective strategy. This approach leads to optimal surgical results without complications.<\/jats:p>","DOI":"10.52054\/fvvo.16.4.055","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T21:22:24Z","timestamp":1734988944000},"page":"489-492","source":"Crossref","is-referenced-by-count":1,"title":["Complete bicorporeal uterus, double cervix, longitudinal obstructing vaginal septum: an integrated approach for one-stop diagnosis and ultrasound-guided endoscopic hymen-sparing treatment"],"prefix":"10.52054","volume":"16","author":[{"given":"F","family":"Bernardini","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Bonetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Pozzati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"La Fera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F","family":"Campolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Naldini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.C.","family":"Testa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U","family":"Catena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2811","published-online":{"date-parts":[[2024,12]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Altinta\u015f A. Uterus didelphys with unilateral imperforate hemivagina and ipsilateral renal agenesis. J Pediatr Adolesc Gynecol. 1998;11:25-7.","DOI":"10.1016\/s1083-3188(98)70103-2"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Alumbreros And\u00fajar MT, Aguilar Gal\u00e1n EV, C\u00e9spedes Casas C. Acute urinary retention caused by OVHIRA syndrome. Int Urogynecol J. 2014;25:699-701.","DOI":"10.1007\/s00192-013-2201-0"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Bolonduro O, Akinpeloye A, Abuzeid OM et al. Herlyn-Werner-Wunderlich syndrome: presentation and surgical management options for five cases. J Gynecol Surg. 2015;31:46-51.","DOI":"10.1089\/gyn.2014.0081"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Borges AL, Sanha N, Pereira H et al. Herlyn-Werner-Wunderlich syndrome also known as obstructed hemivagina and ipsilateral renal anomaly: A case report and a comprehensive review of literature. Radiol Case Rep. 2023;18:2771-84.","DOI":"10.1016\/j.radcr.2023.05.024"},{"key":"ref4","unstructured":"Campo R, Santangelo F, Gordts S et al. Outpatient hysteroscopy. Facts Views Vis Obgyn. 2018;10:115-22."},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Carugno J, Grimbizis G, Franchini M et al. International Consensus Statement for recommended terminology describing hysteroscopic procedures. Facts Views Vis Obgyn. 2021;13:287-94.","DOI":"10.52054\/fvvo.13.4.037"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Fascilla FD, Olivieri C, Cannone R et al. In-office Hysteroscopic Treatment of Herlyn-Werner-Wunderlich Syndrome: A Case Series. J Minim Invasive Gynecol. 2020;27:1640-5.","DOI":"10.1016\/j.jmig.2020.04.013"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Grimbizis GF, Gordts S, Di Spiezio Sardo A et al. The ESHRE\/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28:2032-44.","DOI":"10.1093\/humrep\/det098"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Gungor Ugurlucan F, Dural O, Yasa C et al. Diagnosis, management, and outcome of obstructed hemivagina and ipsilateral renal agenesis (OHVIRA syndrome): is there a correlation between MRI findings and outcome? Clin Imaging. 2020;59:172-8.","DOI":"10.1016\/j.clinimag.2019.11.013"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Kriplani A, Dalai V, Kachhawa G et al. Minimally Invasive Endoscopic Approach for Management of OHVIRA Syndrome. J Obstet Gynaecol India. 2019;69:350-5.","DOI":"10.1007\/s13224-019-01240-4"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Kudela G, Wiernik A, Drosdzol-Cop A et al. Multiple variants of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome - one clinical center case series and the systematic review of 734 cases. J Pediatr Urol. 2021;17:653.e1-653.e9.","DOI":"10.1016\/j.jpurol.2021.06.023"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Ludwin A, Ludwin I, Pity\u0144ski K et al. Differentiating between a double cervix or cervical duplication and a complete septate uterus with longitudinal vaginal septum. Taiwan J Obstet Gynecol. 2013;52:308-10.","DOI":"10.1016\/j.tjog.2013.04.034"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Ludwin A, Ludwin I, Bhagavath B et al. Virginity-sparing management of blind hemivagina in obstructed hemivagina and ipsilateral renal anomaly syndrome. Fertil Steril. 2018;110:976-8.","DOI":"10.1016\/j.fertnstert.2018.07.007"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Pozzati F, Mirandola M, Topozouva G et al. Complete uterine septum, double cervix, and longitudinal vaginal septum: an integrated approach for one-stop diagnosis and ultrasound-guided endoscopic treatment. Facts Views Vis Obgyn. 2023;15:167-70.","DOI":"10.52054\/fvvo.15.2.077"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Purslow CE. A case of unilateral hematokolpos, hematometra and hematosalpinx. BJOG. 1922;29:643.","DOI":"10.1111\/j.1471-0528.1922.tb16100.x"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Sleiman Z, Wehbe GS, Rassy EE et al. A novel surgical intervention for an uncommon entity: laparoscopy-assisted resection of a vaginal septum in obstructed hemivagina and ipsilateral renal anomaly syndrome. J Laparoendosc Adv Surg Tech A. 2019;29:714-6.","DOI":"10.1089\/lap.2018.0592"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Tug N, Sargin MA, \u00c7elik A et al. Treatment of virgin OHVIRA syndrome with hematometrocolpos by complete incision of vaginal septum without hymenotomy. J Clin Diagn Res. 2015;9:QD15-6","DOI":"10.7860\/jcdr\/2015\/15532.6826"}],"container-title":["Facts, Views and Vision in ObGyn"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,2,14]],"date-time":"2025-02-14T05:56:27Z","timestamp":1739512587000},"score":1,"resource":{"primary":{"URL":"https:\/\/fvvo.eu\/articles\/doi\/FVVO.16.4.055"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":17,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,12]]},"published-print":{"date-parts":[[2024,12]]}},"URL":"https:\/\/doi.org\/10.52054\/fvvo.16.4.055","relation":{},"ISSN":["2684-4230","2032-0418"],"issn-type":[{"value":"2684-4230","type":"electronic"},{"value":"2032-0418","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}