title: An unusual presentation of uterine didelphys and obstructed hemivagina.
abstract: BACKGROUND
  Congenital disorders of the genitourinary system can be unpredictable. There are both medical and surgical interventions that can help manage symptoms.
  
  
  METHODS
  A 10-year-old girl was evaluated 6 months post-menarche with dysuria and pelvic pain. Her symptoms were not relieved with menstrual suppression. Evaluation revealed a probable ectopic ureter versus ureterocele and uterine didelphys with suspicion for obstructed hemivagina and hematocolpos. Surgical exploration revealed an obstructed hemivagina with a high vaginal septum. When resection failed, she ultimately underwent a robot-assisted hemihysterectomy, with resolution of her symptoms.
  
  
  CONCLUSIONS
  In this case presentation, a surgical approach was necessary to adequately make a diagnosis. When vaginal septum resection failed, robot-assisted laparoscopic hemi-hysterectomy and resection of a vaginal pouch led to symptom resolution in this pediatric patient with a complex anomaly.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University, New York City, New York, USA. swbcmd@hotmail.com
authors.forename: Sloane
authors.initials: S
authors.lastname: Berger-Chen
authors.forename: Jessica M B
authors.initials: JM
authors.lastname: Ritch
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: John
authors.initials: J
authors.lastname: Evanko
authors.forename: Terry W
authors.initials: TW
authors.lastname: Hensle
mesh_terms: D002648:Child; D053159:Dysuria / Q000209:etiology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D017699:Pelvic Pain / Q000209:etiology; D014599:Uterus / Q000002:abnormalities* / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery