Unit of Obstetrics and Gynecology, Di Venere Hospital, Bari Local Health Authority (Drs. Fascilla and Vicino).
II Unit of Obstetrics and Gynecology, Department of Biomedical Sciences and Human Oncology, Policlinico of Bari, (Drs. Olivieri, Cannone, De Palma, Costantino, and Cicinelli).
J Minim Invasive Gynecol. 2020 Nov-Dec;27(7):1640-1645. doi: 10.1016/j.jmig.2020.04.013. Epub 2020 Apr 19.
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.
赫尔林-韦纳-旺德雷希综合征（HWWs）是一种罕见的女性泌尿生殖道先天性畸形，其特征为三联征，包括双子宫、阴道横隔阻塞和同侧肾发育不全。我们报告了在我们中心治疗的 5 例连续确诊的 HWWs 患者。使用二维/三维超声和腹盆腔磁共振成像进行影像学检查以确认诊断。治疗包括在办公室使用 5 Fr 宫腔镜双极电极进行阴道隔一次性宫腔镜切开术。在初始手术后 1 至 2 个月的随访就诊时，根据需要，通过阴道宫腔镜入路进行诊断性阴道镜检查，并切除多余的阴道组织。在办公室对确诊为 HWWs 的患者进行宫腔镜治疗是一种安全有效的微创治疗方法，可缓解症状并保留生育能力，避免了在手术室环境下使用全身麻醉的费用和风险。我们建议将这种具有挑战性的疾病的管理转移到办公室环境中。
