MRI image features and differential diagnoses of Herlyn–Werner–Wunderlich syndrome

Zhang, Jinlong; Xu, Shengfang; Yang, Lei; Yue, Songhong

doi:10.1080/09513590.2019.1680623

Cited by 15 publications

(23 citation statements)

References 24 publications

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“…Transverse or longitudinal vaginal septum and congenital vaginal atresia may also present with similar clinical manifestations with HWW syndrome and must be included in the differential diagnosis. However, the aforementioned conditions are not accompanied by renal abnormalities 10 . Therefore, the key to suspect HWW syndrome before symptom onset is the concomitant presence of uterine malformation and unilateral renal anomalies.…”

Section: Discussionmentioning

confidence: 99%

Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection

Pittokopitou

Kathopoulis

Πρωτόπαπας

et al. 2021

J of Obstet and Gynaecol

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Herlyn–Werner–Wunderlich (HWW) syndrome is a rare congenital anomaly of Mullerian duct development characterized by uterus didelphys with blind hemivagina and ipsilateral renal agenesis. We present a case of a 29‐year‐old nulliparous woman, who was referred to our hospital complaining of chronic pelvic pain, dyspareunia, and a palpable mass in her vagina. At the age of 12, she underwent surgery because of a didelphys uterus diagnosis. Subsequently, she was operated on twice for endometriomas. At our institution, clinical and imaging findings revealed an obstructed hemivagina setting the diagnosis of HWW syndrome. Some of the various syndrome types may go unnoticed for months or even years after the onset of menstruation. Early diagnosis, followed by proper surgical treatment, is the key to avoid potentially severe complications.

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Section: Discussionmentioning

confidence: 99%

Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection

Pittokopitou

Kathopoulis

Πρωτόπαπας

et al. 2021

J of Obstet and Gynaecol

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“…Developmental abnormalities of the female genital tract include various disorders of the fallopian tubes, uterus, and vagina, with a mean prevalence of 7% [8] . They occur owing to maldevelopment of the Müllerian or paramesonephric ducts [7] . The development of Müllerian ducts is embryologically interlinked to the development of Wolffian or mesonephric ducts, which could explain the frequent association of urologic abnormalities and Müllerian malformations [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Laboratory examinations have revealed that some patients have elevated levels of CA-199 [7] or CA-125 [16] . In this study, both patients showed elevated levels of CA-125 and 1 patient showed elevated level of CA-199, which returned to normal at the postoperative follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrasound examination is an inexpensive and convenient method of screening for HWWS; however, its diagnostic accuracy depends on the experience of the examiner. MRI is the imaging modality of choice [ 6 , 7 ] for the diagnosis and classification of HWWS, as it provides details about uterine morphology, including outline and intrauterine cavity shape and continuity with each vaginal lumen, and the character of the fluids in these cavities. It can also ascertain associated pathologies such as endometriosis, vaginitis, pelvic inflammation, and adhesion, as well as renal agenesis.…”

Section: Discussionmentioning

confidence: 99%

“…Hematocolpos is caused by the retention of menstrual blood in the obstructed hemivagina and is usually detected as a cystic pelvic mass [6] . Surgery is the main treatment, and it includes removal of the vaginal septum and drainage of the effusion [7] ; however, complete removal of the vaginal septum in a single procedure may be difficult in case of local inflammation in the vagina and cervix. Herein, we present 2 cases of HWWS along with their complications.…”

Section: Introductionmentioning

confidence: 99%

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Herlyn–Werner–Wunderlich syndrome and its complications: A report of two cases and literature review

Li¹,

Liu²,

Li³

2021

Radiology Case Reports

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Herlyn–Werner–Wunderlich syndrome (HWWS) is a rare congenital malformation characterized by uterus didelphys, unilateral blind hemivagina, and ipsilateral renal agenesis. The obstructed vagina affects menstrual flow, leading to related clinical symptoms after menarche. However, the age of onset, initial symptoms, and clinical complications differ among patients owing to the different types of vaginal septum. Herein, we report 2 cases. The first case is of a 20-year-old woman who presented with fever; she was diagnosed with vaginitis and pelvic inflammation due to the vaginal septum with ostiole. The second case is of a 12-year-old girl who complained of abdominal pain; she was diagnosed as having pelvic inflammation, omentitis, and suppurative appendicitis due to the atretic vaginal septum.

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New Consideration of Herlyn‐Werner‐Wunderlich Syndrome Diagnosed by Ultrasound

Liu

Zhang

Xia

et al. 2020

J of Ultrasound Medicine

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Objectives-As a rare malformation of the female reproductive system, Herlyn-Werner-Wunderlich syndrome (HWWS) was categorized into 3 classifications. It was recommended recently that, on the basis of the past classification, cervicovaginal atresia without communicating uteri should be newly added as classification 4. The surgical intervention will differ by type. To better optimize patient counseling as well as the preoperative evaluation and planning, our objective was to describe the ultrasound characteristics of each type of HWWS, including the new type.Methods-From January 1995 to November 2015, 37 cases of HWWS in with complete ultrasound information confirmed by surgery in the Peking Union Medical College Hospital were reviewed. We analyzed their ultrasound features, including hematometra, hematocervix, hematocolpos, and an ovarian chocolate cyst.Results-All of the ultrasound images of the 37 patients showed uterus didelphys with ipsilateral renal agenesis. Compared with the other 3 types, classification 4 showed distinctive ultrasound characteristics. Most cases of classification 4 showed hematometra (5 of 7 [71.4%]) and an ipsilateral ovarian chocolate cyst (6 of 7 [85.7%]), which was significantly higher than in the other 3. A rudimentary uterine horn was also a distinctive characteristic in this type. Meanwhile none of the classification 4 cases showed hematocervix or hydrocolpos, which were common signs of the other 3.Conclusions-According to this new classification criteria for HWWS, ultrasound characteristics of the new classification 4 differ from the others. As classification 4 was suggested to have a different surgical option, we should pay attention to its ultrasound characteristics, which might help in providing more information about the treatment and prognosis to the gynecologist.

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MRI image features and differential diagnoses of Herlyn–Werner–Wunderlich syndrome

Cited by 15 publications

References 24 publications

Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection

Herlyn–Werner–Wunderlich syndrome: Report of a delayed diagnosed case with video presentation of the operative technique of vaginal septum resection

Herlyn–Werner–Wunderlich syndrome and its complications: A report of two cases and literature review

New Consideration of Herlyn‐Werner‐Wunderlich Syndrome Diagnosed by Ultrasound

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