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Ginecología y Obstetricia de México

Federación Mexicana de Ginecología y Obstetricia, A.C.
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2014, Number 10

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Ginecol Obstet Mex 2014; 82 (10)

Obstructed hemivagina and ipsilateral renal anomaly: unusual cause of piocolpos. Report a case and review of literature

Cortés-Contreras DK, Juárez-Cruz PM, Vázquez-Flores J, Vázquez-Flores AD
Full text How to cite this article

Language: Spanish
References: 11
Page: 711-715
PDF size: 319.31 Kb.


Key words:

Uterus didelphys, hemivagina, renal agenesis, pyocolpos.

ABSTRACT

OHVIRA (Obstructed hemivagina and ipsilateral renal anomaly) by acronym and abbreviations in English or Herlyn Werner Wunderlich syndrome is a rare congenital malformation caused by an alteration in the Mullerian ducts and Wolffian Ducts. Which is characterized by a triad: uterus didelphys, obstructed and ipsilateral renal agenesis hemivagina still uncertain etiology. Patients are usually asymptomatic until menarche where the most common clinical presentation is pelvic pain, followed by a vaginal or abdominal mass, normal menstrual periods, infertility, and vaginal discharge rarely appears. The case of a female patient of 15 years, nubile with chronic fetid vaginal discharge, initially diagnosed and treated as pelvic inflammatory disease occurs, however because it is an exceptional condition with the background of the patient, by complementary studies were conducted where pelvic ultrasound revealed pyocolpos and absence of left kidney, uterus didelphys, blind hemivagina by other imaging studies, where we could integrate Herlyn-Werner-Wunderlich syndrome.
In conclusion, abnormalities in the development of the Müllerian ducts are difficult to diagnose early, so you must have the embryological knowledge, conduct thorough clinical assessment and detailed picture in whom the condition is suspected to identify malformations coexisting urinary tract and vaginal defects with the importance of preserving reproductive success through appropriate planning of surgical approach, given that the fertility rate in these patients is comparable to the average.


REFERENCES

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  3. The American Fertility Society classifications of adnexal adhesions, distal tubal obstruction, tubal occlusions secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertil Steril 1998;49:944-55.

  4. Chandler TM, Machan LS, Cooperberg PL, Harris AC, Chang SD. Müllerian duct anomalies: from diagnosis to intervention. The British Journal of Radiology 2009;82: 1034-1042.

  5. Park NH, Park HJ, Park CS, et al. Herlyn-Werner-Wunderlich Syndrome with unilateral hemivaginal obstruction, ipsilateral renal agenesis, and contralateral renal thin GBM disease: a case report with radiological follow up. J Korean SocRadiol 2010; 62:383e8.

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  10. White PVK. Herlyn-Werner-Wunderlich Sydrome (HWWS): A Complex Diagnosis Requiring a Multidisciplinary Team. Journal of Pediatric and Adolescent Gynecology 2014;27: 207.

  11. Khalid E, Jalil S, Anwar T, Nausheen S. Congenital female lower genital tract abnormalities: two years experience in a tertiary care hospital. Pak J Surg 2011;27:44-49.




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Ginecol Obstet Mex. 2014;82