VP62.38: Chronic pelvic pain caused by Herlyn–Werner–Wunderlich syndrome: a case report

Herlyn–Werner–Wunderlich (HWW) syndrome is a rare congenital condition which involves uterus didelphys and blind hemivagina associated with ipsilateral renal agenisis. The main symptom of this abnormality is dysmenorrhea and usually established after puberty. We present here a case of investigation and management of this condition with pelvic pain in young female. A 15-year-old young female, menarche at the age of 12 years, with gradually increasing pelvic pain. Ultrasound examination of the pelvis and the abdomen revealed right renal agenesis, uterus didelphys with hematometra, hematocervix in the right uterus with hematocolpos. The MRI imaging confirmed the diagnosis. The patient underwent puncture of the hematometra to relieve the pain then received injection of depot medroxyprogesterone acetate. The vaginoplastie wasn't possible because of the reduced size of the vagina. HWW syndrome is generally asymptomatic until puberty when patients present dysmenorrhea and a palpable pelvic or abdominal mass. MRI is the gold standard for diagnostic with capability of the tissue differentiation. The aim of the treatment is to release the obstruction to relieve the pain and prevent the complications. In conclusion, HWW syndrome causes severe pelvic pain and may lead to number of complications including endometriosis, early detection is the key to alleviating suffering and avoiding potentially serious complications.