title: Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome: management and follow-up.
abstract: OBJECTIVE
  To review the experience at two large referral centers with the syndrome of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), and to review the risks, benefits, and complications of surgical management options.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Children's Hospital Boston and Brigham and Women's Hospital, Boston, Massachusetts.
  
  
  METHODS
  Twenty-seven cases of obstructed hemivagina over a 12-year period.
  
  
  METHODS
  For each patient who presented symptoms, diagnostic studies, anatomic findings, surgical management, outcomes, and complications were reviewed.
  
  
  RESULTS
  The mean age of diagnosis was 14 years. Twenty-three patients had ipsilateral renal anomalies, including 20 patients who had renal agenesis. Two had dysplastic ipsilateral kidneys requiring nephrectomy in infancy. Twenty-six patients underwent vaginal reconstruction, and eight of those additionally underwent laparoscopy for clarification of diagnosis. Six required a two-stage vaginoplasty because of incomplete previous resection (n = 1), infection or anatomic distortion (n = 4), or restenosis (n = 2). Vaginal septum adenosis was seen in eight patients.
  
  
  CONCLUSIONS
  Most patients with OHVIRA syndrome can be treated solely with single-stage vaginoplasty. Routine laparoscopy is not essential to management. Vaginal stenosis is a postoperative possibility, and may be associated with vaginal adenosis.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Smith
authors.forename: Marc R
authors.initials: MR
authors.lastname: Laufer
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D013577:Syndrome; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery