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Federación Mexicana de Ginecología y Obstetricia, A.C.

2019, Number 02

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Ginecol Obstet Mex 2019; 87 (02)

Herlyn-Werner-Wunderlich syndrome: two different presentation modalities. Report of two cases

Sepúlveda-Agudelo J, Jaimes-Carvajal H

Language: Spanish
References: 18
Page: 139-145
PDF size: 321.58 Kb.


ABSTRACT

Background: The Herlyn-Werner-Wünderlich syndrome is a rare Müllerian congenital anomaly, characterized by the association between didelphus uterus, obstruction of the vaginal septum and renal agenesia.
First case: Patient of 13 years, with severe pelvic pain of 8 days of evolution. During the physical examination he reported generalized abdominal pain. Abdominal pelvic ultrasound showed: bicornuate uterus with hematocolpos and nuclear magnetic resonance: single uterus with hematocolpos and right renal agenesis. In laparoscopy the didelphus uterus was evidenced, with hematosalpinx, moderate adherent adhesion syndrome and foci of endometriosis. The incision of the vaginal septum and its resection were made. With this, complete drainage of the hematocolpos was achieved and vaginoplasty was possible; the patient had a good evolution.
Second case: Patient of 30 years, with dysmenorrhea, pelvic pain and regular cycles. In the physical examination two uterine necks were observed: the right one of normal aspect and the left one punctate. The ultrasound showed: uterus didelphy with liquid collection in the middle. Magnetic resonance reported: didelphys uterus and left renal agenesis. The hysteroscopy revealed a tubular cavity in the right neck and in the middle of the uterus. The endometrium and normal right ostium. The left neck was rudimentary and punctate, with leakage of purulent material. The laparoscopy showed two hemiutero with normal tubes and ovaries.
Conclusion: Early diagnosis of this congenital anomaly decreases long-term morbidity, the possibility of endometriosis, impaired fertility and obstetric complications. The treatment is with minimal access techniques that offer more advantages than open surgery.


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