Improvement of dysmenorrhea caused by Herlyn-Werner syndrome through laparoscopic surgery: a case report

Abstract

Girls usually experience only mild pain during their first menstrual cycle, and severe pain at menarche is occasionally indicative of a uterine anomaly.
Case report: An 11-year-old girl, who had been diagnosed with a left renal defect and ureterocele 2 years previously, presented to our emergency room with severe dysmenorrhea 1 day after her second menstrual cycle began. Imaging revealed the presence of a double uterus, left cervical cyst, and ipsilateral renal defect. Thus, she was diagnosed with Wunderlich syndrome. Although cyst drainage was attempted, the wall was too rigid. In addition, uterus bicornis unicollis was noted during laparoscopy. Finally, an intraoperative diagnosis of Herlyn-Werner syndrome was made during laparoscopic left hysterectomy.
Discussion: Herlyn-Werner syndrome, obstructed hemivagina and ipsilateral renal anomaly syndrome, and Wunderlich syndrome are rare Mullerian anomalies that have many common features.
Conclusion: Diagnosis of these syndromes in girls is difficult, and the treatment differs in each case. Hence, flexibility in treatment is essential.