A case report on Herlyn–Werner–Wunderlich syndrome with spontaneous abortion

Abstract

Introduction:Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital abnormality of the urogenital tract characterized by uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. It is usually diagnosed after menarche, with a clinical presentation of dysmenorrhea, recurrent abdominal pain, and irregular menses. However, it is rare to diagnose it during pregnancy, subsequently resulting in spontaneous abortion.Case presentation:A 22-year-old Chinese woman with HWWS whose left uterine pregnancy underwent spontaneous abortion presented with a right perforated obstructed hemivagina and right renal agenesis. The right vaginal septum was resected and the hematocolpos was drained, thereby relieving lower abdominal pain and preserving future fertility.Conclusion:Co-presentation of unilateral renal agenesis and uterus didelphys should encourage clinicians to rule out HWWS. Early diagnosis and subsequent treatment can avoid possible serious complications.

Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection

“…A rare variant of MDAs is the HWW syndrome, characterized by uterus didelphys, bling hemi‐vagina, and ipsilateral renal agenesis. The classification adopted by Rock and Jones in 1980 is widely used internationally and includes complete and incomplete obstruction 1 . In 2018, Zhu et al divided HWW into three types.…”

“…Even if they achieved conception, they are at higher risk of premature delivery (22%) and spontaneous abortions (74%). Also, a cesarean section is required in 82% of the cases 1 …”

“…Resection of the vaginal septum is the most effective treatment of this abnormality leading to immediate relief. It can also prevent long‐term complications, preserve future fertility, and achieve a better pregnancy outcome 1, 3 . The recent years, because many patients with HWW syndrome have an imperforate hymen, minimally invasive approaches such as hysteroscopic resection of the septum have been reported in the literature with excellent results 12 .…”

“…The syndrome was first reported in 1922 by Purslow, but the characteristic triad of uterus didelphys, blind hemi‐vagina, and ipsilateral renal agenesis, was established in 1971 by Herlyn and Werner. Later in 1976, Wunderlich described the association of right renal agenesis with a bicornuate uterus and simple vagina in the presence of an isolated haematocervix 1 . The incidence of the syndrome is estimated between 0.1% and 3.8% 2 .…”

Herlyn-Werner-Wunderlich Syndrome Presenting with Abdominal Pain: A Case Report

“…Herlyn-Werner-Wunderlich (HWW) syndrome is characterized by triad of uterus didelphys with obstructed hemi-vagina and ipsilateral renal agenesis, and it is a rare variant of para mesonephric (Mullerian) duct anomaly [1]. Obstructed hemi-vagina and ipsilateral renal agenesis (OHVIRA) syndrome is another name [2]. It is usually presented with abdominal pain, dysmenorrhea and abdominal mass secondary to hematocolpos [3].…”