Perioperative evaluation in Herlyn-Werner-Wunderlich syndrome

Area of Science:

• Reproductive Medicine
• Gynecologic Surgery
• Medical Imaging

Background:

• Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly characterized by uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis.
• This condition necessitates specialized management due to its complex anatomical presentation.

Observation:

• Three cases of Herlyn-Werner-Wunderlich syndrome were managed surgically at a tertiary care center.
• Diagnosis was confirmed using magnetic resonance imaging (MRI) and ultrasonography.
• All patients underwent successful transvaginal septoplasty and drainage of accumulated menstrual effluent.

Findings:

• The vaginal septum in Herlyn-Werner-Wunderlich syndrome is anatomically distinct: parallel to the patent vaginal canal, less pliable, and closer to the cervix.
• These features cause significant distortion, leading to diagnostic and surgical complexities.
• One patient required septoplasty revision and temporary vaginal stent placement.

Implications:

• Effective surgical management, including septoplasty, is crucial for relieving obstruction of menstrual flow.
• Understanding the unique anatomical challenges is vital for successful surgical outcomes in Herlyn-Werner-Wunderlich syndrome.
• This case series highlights the importance of accurate diagnosis and tailored surgical approaches for this rare condition.