DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193079

Obstructive mullerian anamolies: a case series

Urvashi Miglani, Poonam Laul, V. K. Kadam, Sanjeev Miglani

Abstract


AIM of the study was to review the heterogeneous clinical presentations and management options for some of the obstructive mullerian anomalies through a case series. Background: Müllerian duct anomalies (MDAs) are a miscellaneous group of entities that result from the non-development, defective vertical or lateral fusion, or resorption failure of the müllerian ducts due to genetic mutation. 5 cases of obstructive mullerian anomaly are reviewed. Cases of OHVIRA (obstructed Hemivagina with Renal Agenesis) syndrome, transverse vaginal septum, imperforate hymen and obstructed rudimentary horn of unicornuate uterus are included. Results: We found that cyclical abdominal pain was the most common presenting complaint. There is a high incidence of associated renal anomalies. Psychosocial counselling before treatment is necessary to address the functional and emotional aspects of the patient. Surgical management was done in all patients with good postoperative outcome. Conclusion: Obstructive mullerian anomalies need to be evaluated by a meticulous examination and imaging studies to reach the diagnosis with precision. The treatment has to be tailored to the specific anomaly.


Keywords


Obstructive Mullerian anomalies, Transverse vaginal septum, OHVIRASyndrome.

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References


Speroff L. The uterus. Mitchell C. In: Clinical Gynaecologic Endocrinology and Infertility. 7th Ed. Philadelphia: Lippincott Williams & Wilkins;2005:113.

Grimbizis GF, Camus M, Tarlatzis BC, Bontis JN, Devroey P. Clinical implications of uterine malformations and hysteroscopic treatment results. Hum Reprod Update. 2001;7(2):161-74.

Junqueira BL, Allen LM, Spitzer RF, Kerith L. Müllerian Duct Anomalies and Mimics in Children and Adolescents: Correlative Intraoperative Assessment with Clinical Imaging. Radiographics. 2009;29(4):1085-103.

Amesse LS, Pfaff-Amesse T. Congenital anomalies of the reproductive tract. Falcone T, Hurd WW, eds. Clinical Reproductive Medicine and Surgery. 1st ed. New York: Elsevier. 2007;171.21(2):235-9.

Creighton SM, Hall Craggs MA. Correlation or confusion: The need for accurate terminology when comparing magnetic resonance imaging and clinical assessment of congenital vaginal anamolies. J Paediatr Urol. 2012;8(2):177-80.

Mandava A, Prabhakar RR, Smitha S. OHVIRA syndrome (obstructed hemivagina and ipsilateral renal anomaly) with uterus didelphys, an unusual presentation. J Ped Adolesc Gynecol. 2012;25(2):e23-5.

Vercellini P, Daguati R, Somigliana E, Viganò P, Lanzani A, Fedele L. Asymmetriclateral distribution of obstructed hemivagina and renal agenesis in women with uterus didelphys: institutional case series and a systematic literature review. Fertil Steril. 2007;87(4):719-24. Available at: http://dx.doi.org/10.1016/j.fertnstert.2007.01.173.

Saks EK, Vakili B, Steinberg AC Primary amennorhoea with an abdominal mass at the umbilicus. J Pediatr Adolesc Gynecol. 2009;22(1):e1-3.

Williams Ce, Nakhal RS, Hall Craggs MA, Wood D, Cutner A, Pattison SH et al. Transverse vaginal septae: Management and long term outcome. BJOJ. 2014:121(13);1653-8.

Burgis J. Obstructive Müllerian anomalies: case report, diagnosis, a management. Am J Obstet Gynecol. 2001;185(2):338-44.

Rudimentary Horn. Available at: http://gynecologyandobstetrics.jacobspublishers.com/images/gynec_fig_28.2.jpg

Khati NJ, Frazier AA, Brindle KA. The Unicornuate Uterus and Its Variants: Clinical Presentation, Imaging Findings, and Associated Complications. J Ultrasound Med. 2012;31(2):319-31.

Mullerian Agenesis Diagnosis, Management and Treatment Committee opinion No 562. Am Obstet Gynecol .2018;131(1):e35-42.