Surgical Management and Outcomes of Unilateral Genital Tract Obstruction with Ipsilateral Renal Anomaly Syndrome: A Retrospective Study

Ling Zhang,1,2 Mingfu Wu,1,2 Shuangmei Ye,1,2 Ronghua Liu,1,2 Rong Liu1,2 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Ronghua Liu, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Anv, Wuhan, Hubei, 430030, People’s Republic of China, Email [email protected] Rong Liu, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Anv, Wuhan, Hubei, 430030, People’s Republic of China, Email [email protected]: To systematically conduct a retrospective summary of the optimal surgical strategies and techniques for managing various types of unilateral genital tract obstruction with ipsilateral renal anomaly (UGTOIRA) syndrome, and to establish a comprehensive postoperative follow - up protocol.Methods: The clinical data of patients diagnosed with UGTOIRA syndrome over the past 13 years, encompassing treatment protocols, follow-up assessments, and treatment outcomes, were retrospectively analyzed. Statistical analysis was performed utilizing the SPSS 26.0 statistical software package.Results: All 68 patients underwent reproductive system surgery, with three additionally receiving urological procedures. The age at surgery ranged from 5 to 52 years, with a median of 15 years (interquartile range, 12– 23 years). For Type I, the surgical approach consisted of vaginal oblique septectomy, yielding a 100% clinical cure rate (53/53). Type II-a and II-b were managed with vaginal oblique septectomy and combined vaginal oblique septectomy with ipsilateral cervical plasty, respectively, resulting in an overall 71.4% clinical cure rate (5/7) for Type II. Type III was treated with cervical plasty, achieving a 66.7% clinical cure rate (2/3). Types IV and V were addressed with unilateral hysterectomy and salpingectomy, respectively, both demonstrating 100% clinical cure rates (3/3 and 2/2). The overall cure and improvement rates among the 68 patients were 95.6% (65/68) and 4.4% (3/68), respectively. A one-stage surgical procedure alone was sufficient for cure in 56 cases (82.4%). Significant differences were observed in the distribution of surgical interventions across types and subtypes (P < 0.001), as well as in clinical cure rates among different types and subtypes (P = 0.013).Conclusion: The optimal surgical approach, determined through precise classification of UGTOIRA syndrome, ensures a high clinical cure rate, while systematic postoperative follow-up facilitates the early detection and management of recurrent obstruction.Keywords: UGTOIRA syndrome, uterine malformation, cervical malformation, vaginal malformation, renal agenesis, surgery