OHVIRA: An In-Depth Review with Practical Applications for OBGYNs Worldwide

Purpose of Review Discuss common and uncommon features of obstructed hemivagina with ipsilateral renal anomaly (OHVIRA), including diagnostic strategies, management, referral considerations, and the impact of OHVIRA on reproductive health throughout the patient’s lifespan. Coding and billing resources are also included to aid in accurately capturing the complexity of Müllerian anomalies. Recent Findings Two-thirds of patients with OHVIRA have endometriosis on laparoscopy. Patients with OHVIRA experience normal fertility rates comparable to the general population, but may be at increased risk for certain pregnancy complications such as malpresentation and preterm delivery. Recent reports indicate there may be risk for rare forms of cervical cancer on the previously obstructed side. Strategies for recognition and management may differ in high resource versus low resource settings. Summary OHVIRA is a complex Müllerian anomaly, and diagnosis is often delayed. High resolution MRI is preferred for most accurate pre-surgical diagnosis, however this imaging modality may not be available in low resource settings. Development of accessible advanced imaging tools may provide improved diagnostic capabilities in limited resource settings. Medical management is appropriate for many patients until a comprehensive plan including post-operative considerations is finalized. Surgical correction should be performed by a specialist or subspecialist with appropriate training. Long term reproductive health implications to consider include increased risk of endometriosis, certain pregnancy complications, and possible rare gynecologic cancer risks. Similar content being viewed by others Data Availability No datasets were generated or analysed during the current study.

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Corresponding author Ethics declarations Human and Animal Rights All reported studies/experiments with human or animal subjects performed by the authors have been previously published and complied with all applicable ethical standards (including the Helsinki declaration and its amendments, institutional/national research committee standards, and international/national/institutional guidelines). Competing interests The authors declare no competing interests. Conflict of interest The authors have no conflicts of interest or disclosures. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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