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

Purpose: 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.