In-office Hysteroscopic Treatment of Herlyn-Werner-Wunderlich Syndrome: A Case Series

Herlyn-Werner-Wunderlich syndrome (HWWs) is a rare congenital malformation of the female urogenital track characterized by a triad consisting of didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. We report 5 consecutive cases of patients diagnosed with HWWs treated in our cente...

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Published inJournal of minimally invasive gynecology Vol. 27; no. 7; p. 1640
Main Authors Fascilla, Fabiana Divina, Olivieri, Claudiana, Cannone, Rossella, De Palma, Domenico, Manosperta, Francesco, Costantino, Alfredo Sigfrido, Carugno, Jose, Vicino, Mario, Cicinelli, Ettore, Bettocchi, Stefano
Format Journal Article
LanguageEnglish
Published United States 01.11.2020
Subjects
Adolescent
Adult
Ambulatory Surgical Procedures - methods
Child
Female
Humans
Hysteroscopy - methods
Kidney - abnormalities
Kidney - surgery
Kidney Diseases - congenital
Kidney Diseases - surgery
Syndrome
Treatment Outcome
Urogenital Abnormalities - pathology
Urogenital Abnormalities - surgery
Uterus - abnormalities
Uterus - surgery
Vagina - abnormalities
Vagina - surgery
Young Adult
Müllerian anomalies
Office hysteroscopy
Herlyn-Werner-Wunderlich syndrome
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Summary:Herlyn-Werner-Wunderlich syndrome (HWWs) is a rare congenital malformation of the female urogenital track characterized by a triad consisting of didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis. We report 5 consecutive cases of patients diagnosed with HWWs treated in our center. Imaging studies with 2-dimensional/3-dimensional ultrasound and abdominopelvic magnetic resonance imaging were obtained to confirm the diagnosis. The treatment consisted of a 1-step surgical in-office hysteroscopic incision of the vaginal septum using 5 Fr hysteroscopic bipolar electrodes. At the follow-up visit, between 1 and 2 months after the initial procedure, the patients underwent a diagnostic vaginoscopy with excision of exceeding vaginal tissue if needed, performed with a vaginal hysteroscopic approach. In-office hysteroscopic treatment of patients diagnosed with HWWs is a safe and effective, minimally invasive treatment modality that provides symptomatic relief and preserves fertility, avoiding the cost and risks of the use of general anesthesia in an operating room setting. We recommend shifting the management of this challenging condition to the office setting.
ISSN:1553-4669
DOI:10.1016/j.jmig.2020.04.013