CASE REPORT article
Front. Med.
Sec. Obstetrics and Gynecology
Late-Onset OHVIRA Syndrome in a 49-Year-Old Woman with Severe Dysmenorrhea: A Case Report on Vaginoscopic Management
Provisionally accepted
- Faculty of Medicine, Harran University, Şanlıurfa, Türkiye
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OHVIRA syndrome is a rare Müllerian duct anomaly characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Although typically diagnosed in adolescence, it can rarely present later in life. We present the case of a 49-year-old woman who presented with severe dysmenorrhea and intermittent spotting. Imaging studies, particularly MRI, confirmed the diagnosis of OHVIRA syndrome by revealing a didelphic uterus with hematometra and hematocolpos secondary to a right-sided obstructed hemivagina, along with right renal agenesis. The patient was successfully managed with vaginoscopic and hysteroscopic resection of the vaginal septum. Postoperatively, her symptoms resolved completely, with no recurrence observed at six-month follow-up. This case contributes to the literature by documenting one of the latest known presentations of OHVIRA syndrome, reinforcing that a high index of suspicion for Müllerian anomalies must be maintained regardless of patient age. It demonstrates that a partially draining orifice can mask classical symptoms for decades and confirms the long-term efficacy of a minimally invasive surgical approach for both diagnosis and treatment.
Keywords: Late-onset presentation, Müllerian duct anomalies (MDA), OHVIRA syndrome, uterus didelphys, Vaginoscopic resection
Received: 16 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 KIZILDEMİR, Tammo, İncebiyik, SAK and SAK. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: YUSUF ZİYA KIZILDEMİR
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