Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Cheng, Chunxia; Subedi, Jigyasa; Zhang, Aiqian; Johnson, Grace; Zhao, Xingping; Xu, Dabao; Guan, Xiaoming

doi:10.1038/s41598-019-56471-2

Cited by 30 publications

(45 citation statements)

References 30 publications

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“…The recent years, because many patients with HWW syndrome have an imperforate hymen, minimally invasive approaches such as hysteroscopic resection of the septum have been reported in the literature with excellent results 12 . “No‐touch” vaginoscopic technique is appropriate for adolescent patients with narrow, underdeveloped vaginas with intact hymens 13 . This way, the patient may have symptom relief while maintaining hymenal integrity.…”

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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“…In 72.4% of cases, the classic form is presented -uterus didelphys, hemivagina obstructed by the septum and ipsilateral renal agenesis -, but many variations in the anatomical structures involved are recognized 8 . Classification for the HWWS suggests division according to the shape of the vaginal septa in type I: unperforated diagonal septum, type II: perforated oblique septum, and type III: unperforated diagonal septum with cervical fistula 2,5,9 . Type I is the most frequent and also observed in the case presented in the current report.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of HWWS requires radiological evidence of uterus didelphys, vaginal septum, and ipsilateral renal agenesis, which is often associated with hematocolpos and hematometra. Surgical treatment must be performed early to relieve symptoms and prevent longterm complications related to retrograde menstrual flow, including piocolpo, endometriosis, and pelvic adhesions 2 .…”

Section: Introductionmentioning

confidence: 99%

importância do exame clínico no reconhecimento da síndrome de Herlyn-Werner-Wunderlich: relato de caso

Souza¹,

Valadares

Mota³

et al. 2021

Rev. Med. (São Paulo)

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A síndrome de Herlyn-Werner-Wunderlich (SHWW) é uma doença congênita rara dos ductos müllerianos, em que há útero didelfo, obstrução de hemivagina obstruída por septo e agenesia renal ipsilateral. A apresentação clínica mais comum é dor pélvica progressiva, dismenorreia e massa palpável. Em alguns casos a paciente pode apresentar menstruação normal devido a obstrução de apenas uma hemivagina, fato que resulta em atraso no diagnóstico. Relato do caso: Paciente, 13 anos, sexo feminino, com queixa de dor pélvica intermitente e progressiva, há um ano, associada a irregularidade menstrual, é atendida em hospital terciário. Realizada propedêutica radiológica armada e suprimido o exame físico ginecológico inicial, paciente é erroneamente diagnosticada com torção de cisto ovariano e submetida a laparotomia exploradora. Em pós-operatório, após reavaliação da história clínica e realização de exame ginecológico, evidenciou-se uma anormalidade anatômica em região de vestíbulo vaginal, compatível com septo vaginal e hematocolpo. Realizada colpotomia com drenagem de aproximadamente 900 ml de sangue de aspecto achocolatado e marsupialização do septo vaginal. Conclusões: Denota-se a importância do exame clínico para conclusão diagnóstica precoce e para evitar procedimentos cirúrgicos desnecessários, em especial na conduta de casos raros e intrigantes como a SHWW.

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“…Other Mullerian anomalies requiring surgery include an obstructed hemivagina with ipsilateral renal agenesis [12] (Fig. 2).…”

Section: Likely Gynaecological Scenariosmentioning

confidence: 99%

Adolescent gynaecology: anaesthetic and peri‐operative care implications

Crouch

Molyneux

2021

Anaesthesia

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Summary Adolescents represent a quarter of the world’s population, yet their specific healthcare needs have often not been acknowledged. Whilst many operations in this population will be performed in specialist tertiary centres and children’s hospitals, it is likely that care will be sought in a variety of healthcare settings, and so it is important to have an understanding of the particular approach to this age group. Paediatric and adolescent gynaecology emerged as a speciality in 2000 with the inauguration of the British Society for Paediatric and Adolescent Gynaecology, a specialist society of the Royal College of Obstetricians and Gynaecologists. This is a multidisciplinary group, comprising paediatricians, paediatric surgeons, psychologists and nurses, although the majority of the members are gynaecologists. In this review, we will describe the peri‐operative implications of adolescent gynaecological surgery and the considerations that need to be applied to this specific age group, such as consent, the operative setting and key personnel. We will also discuss specialist situations which are likely to fall to an adolescent gynaecology setting, such as management of those with Mullerian abnormalities, which often present with pelvic pain in adolescence. We discuss those with a history of ritual female genital cutting (female genital mutilation), trans men and those with significant learning difficulties. In all circumstances, teamwork, reflection and pragmatism are key.

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Vaginoscopic Incision of Oblique Vaginal Septum in Adolescents with OHVIRA Syndrome

Cited by 30 publications

References 30 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

importância do exame clínico no reconhecimento da síndrome de Herlyn-Werner-Wunderlich: relato de caso

Adolescent gynaecology: anaesthetic and peri‐operative care implications

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