Herlyn-Werner-Wunderlich Syndrome: A Case Report of a Variant Form & Novel Treatment Technique

Abstract

Uterine malformations occur with an incidence of about 7 - 10%. Complex malformations are rare. Herlyn-Werner-Wunderlich Syndrome (HWW) describes a triad of: Uterine Didelphys, Saggital Vaginal Septum and Ipsilateral Renal agenesis. Patients present at a young age with increasing dysmenorrhea and partial hematocolpos. Treatment can be challenging due to working in the virginal vagina and preserving the hymenal ring. This is extremely important in cultures where surgical vaginal manipulation is prohibited and special permission is needed.This technique describes the use of vaginoscopy as a guide to the operative site while allowing for excellent visualization. This video shows a minimally invasive technique which spares the hymenal ring and maintains patency of the canal after the vaginal septum is incisied. Uterine malformations occur with an incidence of about 7 - 10%. Complex malformations are rare. Herlyn-Werner-Wunderlich Syndrome (HWW) describes a triad of: Uterine Didelphys, Saggital Vaginal Septum and Ipsilateral Renal agenesis. Patients present at a young age with increasing dysmenorrhea and partial hematocolpos. Treatment can be challenging due to working in the virginal vagina and preserving the hymenal ring. This is extremely important in cultures where surgical vaginal manipulation is prohibited and special permission is needed. This technique describes the use of vaginoscopy as a guide to the operative site while allowing for excellent visualization. This video shows a minimally invasive technique which spares the hymenal ring and maintains patency of the canal after the vaginal septum is incisied.