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

Fabiana Divina Fascilla, Claudiana Olivieri, Rossella Cannone, Domenico De Palma, Francesco Manosperta, Alfredo Sigfrido Costantino, Jose Carugno, Mario Vicino, Ettore Cicinelli, Stefano Bettocchi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of Minimally Invasive Gynecology
DOIs
StateAccepted/In press - 2020

Keywords

  • Herlyn-Werner-Wunderlich syndrome
  • Müllerian anomalies
  • Office hysteroscopy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Fascilla, F. D., Olivieri, C., Cannone, R., De Palma, D., Manosperta, F., Costantino, A. S., Carugno, J., Vicino, M., Cicinelli, E., & Bettocchi, S. (Accepted/In press). In-office Hysteroscopic Treatment of Herlyn-Werner-Wunderlich Syndrome: A Case Series. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2020.04.013