Presentation
Patients with OHVIRA usually present soon after menarche with dysmenorrhoea, pelvic pain or pelvic mass. Rarely, a patient may present in early adulthood with infertility. [birpublications.org]
It usually presents at puberty with pelvic pain, but rarely can present in neonates or in adulthood in the form of pyometra, ischiorectal swelling, urinary obstruction, and primary infertility. [1], [2], [3], [4] Since this condition can be treated by [ijri.org]
Therefore, in all patients who present an MDA, it is imperative to investigate the urinary tract. [link.springer.com]
First, this was a retrospective study, which presents potentials for selection bias. The study also included a small number of subjects, although it is presently the largest single-institution study. [journals.plos.org]
Entire Body System
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Rigor
Therefore, more frequent and rigorous obstetric monitoring is required to identify potential obstetric complications. In our case, we performed serial transvaginal ultrasounds, from the twentieth week forward, for preterm birth screening. [thieme-connect.com]
Gastrointestinal
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Abdominal Pain
All patients except one, who required operation due to abdominal pain at 84 months, demonstrated problems before the age of five. [journals.plos.org]
Three patients presented with abdominal pain during puberty. Four patients were detected by prenatal ultrasonography. One two-year-old patient was accidentally found by an imaging study of another disease. [jstage.jst.go.jp]
Case Report A 16-year-old unmarried girl presented with spasmodic and periodic lower abdominal pain with amenorrhea for 4 months. [mamcjms.in]
We describe imaging findings in a 14-year-old female patient who presented with cyclical lower abdominal pain. [ijamhrjournal.org]
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Severe Abdominal Pain
Patient 3: an example of differential diagnosis A 13-years-old female presented with severe abdominal pain. She reported that the pain had begun a few months earlier and had subsequently worsened over the past several weeks. [link.springer.com]
Musculoskeletal
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Neck Pain
When enquired about the history of backache or neck pain, the patient complained of occasional neck stiffness. [birpublications.org]
Neurologic
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Excitement
The MRI was performed on a 1.5 T GE Signa Excite (General Electronics Co., Milwaukee, WI). [birpublications.org]
Urogenital
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Vaginal Bleeding
Vaginal aspiration was performed at 2 months ( Table 2 ); the aspirated fluid was hemorrhagic fluid originating from neonatal vaginal bleeding. [journals.plos.org]
The patient denied any recent abdominal trauma, abnormal vaginal bleeding, nausea, vomiting or diarrhea. A bimanual physical examination indicated a right-sided cystic and tender pelvic mass, movable, mildly tender to palpation. [link.springer.com]
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Decreased Renal Function
Regarding upper urinary tract anomalies, the problems that were either related to accompanying urologic anomalies or arising from decreased renal function were recorded. Serum creatinine, blood pressure, and urinalysis were evaluated periodically. [journals.plos.org]
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Cervical Incompetence
Cervical incompetence is not usually associated with uterus didelphys, and therefore cerclage is not routinely used. [thieme-connect.com]
Treatment
The clinical diagnosis is very challenging and requires imaging studies in which ultrasound and MRI play an essential role in the diagnosis, classification and treatment plan. [ncbi.nlm.nih.gov]
Treatment is surgical, with resection of the septum dividing the two hemivaginas in order to relieve the obstruction. [radiopaedia.org]
Table I Anatomic variants and surgical treatment. [academic.oup.com]
The treatment consists of vaginal septectomy and marsupialization of the blind hemivagina to maintain patency. Long-term outcome is quite good with expectation of normal fertility in most cases. [jpss.eu]
Prognosis
Irrespective of imaging modality, the typical findings are: duplication of the uterus, cervix and vagina unilateral hematocolpos or haematometrocolpos absent kidney on the same side as the uterovaginal obstruction Gartner duct cysts Treatment and prognosis [radiopaedia.org]
Opportune diagnosis and treatment achieve complete improvement of symptoms, adequate reproductive prognosis and avoid major complications such as endometriosis, pelvic adhesions and infertility. [ncbi.nlm.nih.gov]
Batt RE, Mitwally MF (2003) Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy. J Pediatr Adolesc Gynecol 16:337–347 PubMed CrossRef 38. [springermedizin.de]
Future research should analyze the relationship between the different anatomic variants found in this syndrome and their clinical findings (referring particularly to obstetrical prognosis) to improve counselling to patients at the moment of diagnosis. [academic.oup.com]
Uterus didelphys with an imperforate hemivagina is the least common abnormality of the Mullerian ducts, but has the best prognosis in terms of alleviation of symptoms and future fertility of these patients. [omicsonline.org]
Etiology
In the right paramedian side, at the level of the Douglas, posterior to the ideal point of continuity between uterus and rudimentary horn, there were some adjacent nodules most likely of endometrial etiology (14 mm, 38 mm in total) (Figure 9 ). [link.springer.com]
The clinical and etiologic implications are discussed. 9 1988 byGrune & Stratton. Inc. INDEX WORDS: Double uterus; didelphys uterus. [vdocuments.us]
Congenital developmental anomalies of the Müllerian ducts are a significant etiological factor of infertility, and are associated with an increment in obstetrical complication. [thieme-connect.com]
Epidemiology
Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol. 2010;25: 1219–1224. pmid:19421783 View Article PubMed/NCBI Google Scholar 9. Mandava A, Prabhakar RR, Smitha S. [journals.plos.org]
Pathophysiology
The purpose of this review is to demonstrate the pathophysiology, clinical manifestations, diagnostic methods and treatment of the obstructed hemivagina and ipsilateral renal anomaly syndrome. [ncbi.nlm.nih.gov]
The underlying pathophysiological mechanism is potentially the increased risk of retrograde menstruation: because of the obstructed vaginal outflow, the risk of endometrial tissue reflux through the fallopian tube, which can result in retrograde endometriosis [link.springer.com]
Prevention
Batt RE, Mitwally MF (2003) Endometriosis from thelarche to midteens: pathogenesis and prognosis, prevention and pedagogy. J Pediatr Adolesc Gynecol 16:337–347 PubMed CrossRef 38. [springermedizin.de]
Conclusions It could be desirable to achieve to an early diagnosis and treatment of HWW syndrome, in order to relieve acute symptoms, preserve normal fertility and prevent several medical complications. [link.springer.com]
Mould prepared with amnion and foam was placed over the right side of vagina to prevent reobstruction due to circumferential scarring and vaginal stenosis. [mamcjms.in]
Expectant mothers are often manages with cervical sutures and C-sections to prevent fetal distress during labour. References [ edit ] Mandava, Anitha; Prabhakar, R. R.; Smitha, S. (2012-04-01). [en.wikipedia.org]