title: Multidisciplinary approach for management of obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome and rectal prolapse.
abstract: OBJECTIVE
  Müllerian duct anomalies are frequently associated with congenital anomalies of other organ systems, and in particular, the urinary system. A multidisciplinary approach is often required for successful diagnosis and surgical management of complex pelvic anomalies. The objective of this video is to provide a guide for diagnosis of complex female pelvic anomalies and robotic-assisted approach to surgical management with a multidisciplinary team of surgeons.
  
  
  METHODS
  The patient presented is a 24-year-old nulligravida with obstructed hemivagina and ipsilateral renal dysplasia, ipsilateral ectopic ureter, and rectal prolapse. This video outlines the methods used to obtain the correct diagnosis and steps for successful treatment using a robotically assisted surgical approach.
  
  
  RESULTS
  Complex Müllerian anomalies involving multiple organ systems may require the use of advanced three-dimensional imaging to achieve the correct diagnosis, and a minimally invasive surgical approach with robotic assistance is an effective strategy for management.
  
  
  CONCLUSIONS
  A multidisciplinary approach is often required to successfully diagnose and treat women with complex Müllerian anomalies.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospitals Case Medical Center, Cleveland, OH, USA, david.sheyn@uhhospitals.org.
authors.forename: David
authors.initials: D
authors.lastname: Sheyn
authors.forename: Robert
authors.initials: R
authors.lastname: Abouassaly
authors.forename: Raj
authors.initials: R
authors.lastname: Paspulati
authors.forename: Tatiana
authors.initials: T
authors.lastname: Sanses
mesh_terms: D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D012005:Rectal Prolapse / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D013577:Syndrome; D014564:Urogenital Abnormalities / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult