The gynecological examination and investigation confirmed the diagnosis of uterus didelphys, transverse vaginal septum, and ipsilateral renal agenesis with hematocolpos
, representing the most common form of the so-called Herlyn-Werner-Wunderlich syndrome.
The details of the patient's condition were discussed with the patient and her parents, including the complications of outflow obstruction to the right vagina which can lead to hematocolpos
, hematometra, hematosalpinx, and later may cause a retrograde bleeding, chronic pelvic pain, endometriosis, and infertility.
Management of hematocolpos
in adolescent with transverse vaginal septum.
Children may present with mucocolpos, whereas adolescents develop hematocolpos
. If a small perforation is present, pyohematocolpos may result from ascending infection.
(7) Graham-Brown et al, (10) reported another case who developed hematocolpos
due to complete vaginal stenosis following SJS in pregnancy.
For diagnosis, ultrasonography can be used as primary modality that can show utero vaginal duplication, hematocolpos
or hematometra and absent ipsilateral kidney.
The best time for surgery in these patients is approximately at the time of menstruation, particularly in patients with Classification 1.1, as a large distended hematocolpos
is easy to visualize and palpate, which aids in resection.
The case is normally diagnosed following an episode of postmenarche pelvic pain secondary to hematocolpos
. (2) Early diagnosis is imperative to prevent further complications related to urogenital anomalies that may lead to infertility.
Although some amount of hematocolpos
and/or hematometra may be present at diagnosis, the volume may not be sufficient to cause obstructive symptoms.
MR imaging of vaginal agenesis with hematocolpos
. J Comput Assist Tomogr.
secondary to imperforate hymen".International Journal of Emergency Medicine 3 (4): 481-482.