Pregnancy after pyocolpos due to Herlyn-Werner-Wunderlich Syndrome

Introduction Herlyn-Werner-Wunderlich Syndrome (HWWS), characterized by the triad of uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis, is a rare congenital anomaly of the urogenital tract. Symptoms present shortly after menarche when hematocolpos develops during menstruation resulting in dysmenorrhea and a pelvic mass.

Material and method: Case report of the medical findings.

Results A 23-year-old woman presented herself as an emergency with acute pelvic pain in the last two days. Menarche had occurred at the age of 15 years with sporadic lower abdominal pain. In the clinical examination, the patient complained of a pressure intolerance of the entire abdomen. In the gynecological examination, the entrance to the vagina could only be visualized after a sonographic check-up, thereafter the vagina could be inspected, and pus emptied. In addition, a mass on the right side was palpable. The ultrasound confirmed HWWS. Antibiotic therapy was initiated based on suspected adnexitis.

After 3 days without clinical recovery we performed a surgical therapy by vaginal septum resection and drainage of the pyocolpos.

Two years later the patient had a spontaneous conception with a complication-free pregnancy. The patient delivered a healthy baby by caesarean in the 39^th gestational week, boy 2550g, APGAR 8/9/10, pH 7.32.

Conclusion HWWS should be suspected in cases with cyclic pelvic pain and also in neonatal cases with any renal malformations. Monitoring HWWS in the puberty can prevent delayed diagnosis and secondary infection like pyocolpos by obstructed hemivagina.

HWWS can have successful pregnancy in 87 %.

Publication History

Article published online:
07 October 2020