A rare case of pelvic pain caused by Herlyn-Werner-Wunderlich Syndrome in an adult

Lucky Savitry Widyakusuma, Yuyun Lisnawati, Sri Pudyastuti, Agrifa Hasiholan Haloho
International journal of surgery case reports · 2018 · vol. 49(C) , pp. 106–109 · doi:10.1016/j.ijscr.2018.06.022 · PMID:29980030 · PMC6037907 · W2810650889
article OA: gold CC0 ⤵ 2 in-corpus citations
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This paper reports a case of a 23-year-old woman with Herlyn-Werner-Wunderlich Syndrome, characterized by uterus didelphys and obstructed hemivagina, who experienced pelvic pain relieved by vaginal septum excision and vaginoplasty.

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Abstract

INTRODUCTION: Herlyn-Werner-Wunderlich Syndrome (HWWs) is a rare congenital anomaly. This abnormality has 5% percentage of the total Mullerian dysgenesis. The symptomatic patients come with varies condition, such as urinary incontinence, urinary retention endometriosis, pelvic infection and acute pelvic pain. Here we present investigation and management of HWWs with pelvic pain in adult woman. PRESENTATION OF CASE: A 23 years old woman came with pelvic pain. We found abnormalities of HWW syndrome i.e. uterus didelphys with obstructed hemivagina and right renal agenesis through ultrasound imaging, CT scan and MRI. After concluding the diagnosis, the patient underwent vaginal septum excision and vaginoplasty procedures to relieve obstruction which was the cause of pelvic pain. The symptom was improved after surgery and she felt no more pain after a year of follow up. DISCUSSION: The main symptom of HWWs is dysmenorrhea associated with obstruction mass or endometriosis. MRI with capability of tissue differentiation is the gold standard for diagnostic. The primary purpose of surgery is to release the obstruction and to prevent further complication. CONCLUSION: Rarely, HWWs causes an acute pelvic pain with secondary cystic mass finding. Surgery aimed to release obstruction will improve this symptom.

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Condition tags

endometriosisdysmenorrhea

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