Herlyn-Werner-Wunderlich Syndrome with Hematopyocolpos and Cystocele: A Case Report

Introduction: Herlyn-Werner-Wunderlich Syndrome (HWWS) is a rare congenital anomaly of female urogenital tract caused by abnormalities in the development of the Mullerian ducts resulting in uterus didelphys, obstructed hemivagina, and associated ipsilateral renal anomaly. HWWS patients are usually diagnosed around or after puberty. We present the case investigation of HWWS patient with hematopyocolpos and cystocele. Case Report: A 14-year-old girl came with abdominal enlargement and lower abdominal pain. A cystic mass with tenderness on the right iliac fossa was found on abdominal examination. Per-rectal examination revealed a cystic mass with a smooth surface in the right lateral region of the midline. Theabdominal ultrasound revealed a single left kidney, uterus didelphys, and hematocolpos in right hemivagina. Bulging cystic mass with smooth surface on right lateral vaginal wall was found from vaginal examination under general anasthesia. The patient underwent right vaginal wall excision, neovaginal reconstruction, and anterior colporrhaphy. One month post-operation follow-up, there're improvement condition and menstruation without lower abdominal pain. Conclusion: Lower abdominal pain with a cystic mass finding on abdominal examination and accompanying hematocolpos after menarche suggests HWWS. Early detection and management can prevent the later complications of these syndrome.