DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.072

Pages: 1171-1174

Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) syndrome is a rare congenital Müllerian duct anomaly defined by the triad of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. It typically presents shortly after menarche with cyclic pelvic pain and dysmenorrhea due to hematocolpos. We report an atypical case of an 18-year-old woman presenting with dyspareunia despite regular menstrual cycles. Pelvic ultrasound suggested a uterus didelphys associated with a cystic pelvic lesion. Magnetic resonance imaging (MRI) confirmed a uterus didelphys with a double vaginal cavity, including an obstructed hemivagina, and ipsilateral renal agenesis. The anomaly was classified as U3b C2 V3 according to the ESHRE system. This case highlights the pivotal role of MRI in diagnosing Müllerian anomalies and emphasizes that OHVIRA syndrome may present without classic obstructive symptoms.