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  1. Case Report: Management of a Rare Case of Neonatal Uterovaginal Prolapse Using a Vaginal Plug
    Gunasagran Y, Wahab AVA
    J Pediatr Adolesc Gynecol, 2021 Sep 10.
    PMID: 34517116 DOI: 10.1016/j.jpag.2021.09.001
    Congenital neonatal uterovaginal prolapse is a rare occurrence that is usually detected after delivery. Most cases are managed conservatively, although there are more invasive approaches to management. We report a case of a neonate with uterovaginal prolapse that we successfully managed conservatively. In this case, a vaginal plug made from a wet cotton ball and condom was inserted into the vaginal canal. To further reinforce the vaginal plug, a pressure garment was applied over the neonate's diaper. A trial of noninvasive methods that are simple and cost-effective should always precede other, more invasive methods in managing cases such as this.
  2. Obstructed Hemivagina Ipsilateral Renal Agenesis (OHVIRA) Syndrome-A Retrospective Cohort Analysis of the Sabah Population
    Lim LM, Sivapatham L, Chong ASL, Wahab AVA
    J Pediatr Adolesc Gynecol, 2023 Dec;36(6):541-544.
    PMID: 37451429 DOI: 10.1016/j.jpag.2023.07.002
    OBJECTIVES: The objectives of the study were to compare the demographic characteristics, presenting complaints, timeliness of diagnosis, and treatments given to all patients diagnosed with obstructive hemivagina ipsilateral renal agenesis (OHVIRA) between the adolescent group (age 10-19) and the adult group (age 20 and above) and to propose a feasible screening test consisting of routine bedside ultrasound to detect renal anomalies in addition to pelvic ultrasound during the assessment of females with gynecologic complications in resource-limited settings.

    METHOD AND ANALYSIS: We conducted a retrospective cohort analysis of all patients with OHVIRA at our institution, Sabah Women and Children's Hospital, Malaysia, between the 2013 and 2022. Data were collected by reviewing patients' medical notes.

    RESULTS: There were a total of 18 patients diagnosed with OHVIRA from 2013 to 2022, aged 10-41 years old. Nine patients (50%) presented during adolescence. Most (88.9%) came with symptoms such as abdominal pain, urinary symptoms, abnormal uterine bleeding, foul-smelling vaginal discharge, and primary infertility, whereas only 2 patients (11.1%) were asymptomatic and diagnosed incidentally. Acute abdomen was more common in the adolescent group (P = .015). No significant difference was found on the side of the renal anomaly.

    CONCLUSION: Presenting symptoms vary and are often mimicked other gynecologic or surgical conditions, making the diagnosis difficult and delayed. Some patients were incidentally diagnosed while being managed for other problems, and it was not uncommon to have unnecessary surgery before the correct diagnosis was made. We suggest that all female patients with abdominal and pelvic complaints should be screened for renal anomaly during pelvic scan to improve diagnostic rates.

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