International Journal of Clinical Obstetrics and Gynaecology

OHVIRA syndrome also known as Herlyn Werner Wunderlich syndrome is an extremely rare mullerian anomaly. The incidence is very small. Only isolated cases have been recorded and published. OHVIRA represents Obstructive HemiVagina and Ipsilateral Renal Agenesis (OHVIRA). It presents with a triad of obstructive vaginal septum, ipsilateral renal anomalies and various types of uterine malformations. Symptoms usually begin post menarche. Patients present with cyclical abdominal pain or severe dysmenorrhea, chronic pelvic pain or prolonged spotting. This is due to the underlying obstruction by the vaginal septum causing hematocolpos and hematometra. Although 3D ultrasound and MRI are excellent modalities for diagnosis of OHVIRA syndrome, we intend to emphasise on the added advantages of upcoming technology such as 3D virtual reality reconstruction, which helps to plan our surgery precisely. We present here, 2 cases of OHVIRA syndrome with different presentations, diagnosis aided by radiological imaging and immersive virtual reality and managed by minimal invasive surgery. We also aim to discuss here, different theories in its pathophysiology and different techniques in the hysteroscopic management of OHVIRA syndrome.