Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study

Abstract Background This study aimed to describe the clinical characteristics of patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA)/Herlyn-Werner-Wunderlich (HWW) syndrome and to evaluate the efficacy of minimally invasive management strategies. Methods This cohort study invo...

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Main Authors: Tomoko Oishi, Kota Konishi, Mamiko Okamoto, Chiharu Mizoguchi, Mitsutake Yano, Yasushi Kawano, Eiji Kobayashi
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Women's Health
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Online Access:https://doi.org/10.1186/s12905-025-03905-x
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author Tomoko Oishi
Kota Konishi
Mamiko Okamoto
Chiharu Mizoguchi
Mitsutake Yano
Yasushi Kawano
Eiji Kobayashi
author_facet Tomoko Oishi
Kota Konishi
Mamiko Okamoto
Chiharu Mizoguchi
Mitsutake Yano
Yasushi Kawano
Eiji Kobayashi
author_sort Tomoko Oishi
collection DOAJ
description Abstract Background This study aimed to describe the clinical characteristics of patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA)/Herlyn-Werner-Wunderlich (HWW) syndrome and to evaluate the efficacy of minimally invasive management strategies. Methods This cohort study involved a retrospective review of the medical records of patients diagnosed with OHVIRA/ HWW syndrome. Data on chief complaints, diagnostic findings, associated complications, anatomical variations, and therapeutic interventions were extracted. Results A total of nine cases were eventually included. The mean age of symptom onset was 23.1 years, whereas the mean age at diagnosis was 20.3 years. Six patients (67%) were diagnosed with OHVIRA syndrome, and an equal proportion (67%) had left-sided abnormalities. Therapeutic interventions were performed in five cases (56%). Statistically, diagnosis after menarche and severe dysmenorrhea was positively correlated with therapeutic interventions (p = 0.048 and p = 0.040, respectively). In one case, symptoms appeared after amenorrhea due to pregnancy, leading to a first-time diagnosis of HWW syndrome in the patient. Management strategies included traditional transvaginal surgery in three patients, vaginoscopic surgery in one patient, and hormone therapy without surgical intervention in another. Conclusions Early diagnosis before menarche reduces the risk of therapeutic intervention, while severe dysmenorrhea is a risk factor for therapeutic interventions. Amenorrhea due to pregnancy can result in the re-closure of a pre-existing communicating tract. Minimally invasive management approaches, such as hormone therapy without surgery or vaginoscopic incision, can be effective.
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spelling doaj-art-e5dcc48039a8480b99f096d56b8827d42025-08-20T04:02:56ZengBMCBMC Women's Health1472-68742025-07-012511610.1186/s12905-025-03905-xDifferent interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort studyTomoko Oishi0Kota Konishi1Mamiko Okamoto2Chiharu Mizoguchi3Mitsutake Yano4Yasushi Kawano5Eiji Kobayashi6Department of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityDepartment of Obstetrics and Gynecology, Faculty of Medicine, Oita UniversityAbstract Background This study aimed to describe the clinical characteristics of patients with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA)/Herlyn-Werner-Wunderlich (HWW) syndrome and to evaluate the efficacy of minimally invasive management strategies. Methods This cohort study involved a retrospective review of the medical records of patients diagnosed with OHVIRA/ HWW syndrome. Data on chief complaints, diagnostic findings, associated complications, anatomical variations, and therapeutic interventions were extracted. Results A total of nine cases were eventually included. The mean age of symptom onset was 23.1 years, whereas the mean age at diagnosis was 20.3 years. Six patients (67%) were diagnosed with OHVIRA syndrome, and an equal proportion (67%) had left-sided abnormalities. Therapeutic interventions were performed in five cases (56%). Statistically, diagnosis after menarche and severe dysmenorrhea was positively correlated with therapeutic interventions (p = 0.048 and p = 0.040, respectively). In one case, symptoms appeared after amenorrhea due to pregnancy, leading to a first-time diagnosis of HWW syndrome in the patient. Management strategies included traditional transvaginal surgery in three patients, vaginoscopic surgery in one patient, and hormone therapy without surgical intervention in another. Conclusions Early diagnosis before menarche reduces the risk of therapeutic intervention, while severe dysmenorrhea is a risk factor for therapeutic interventions. Amenorrhea due to pregnancy can result in the re-closure of a pre-existing communicating tract. Minimally invasive management approaches, such as hormone therapy without surgery or vaginoscopic incision, can be effective.https://doi.org/10.1186/s12905-025-03905-xAmenorrheaCommunicating tractMenstruationMulticystic dysplastic kidneyPregnancy
spellingShingle Tomoko Oishi
Kota Konishi
Mamiko Okamoto
Chiharu Mizoguchi
Mitsutake Yano
Yasushi Kawano
Eiji Kobayashi
Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
BMC Women's Health
Amenorrhea
Communicating tract
Menstruation
Multicystic dysplastic kidney
Pregnancy
title Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
title_full Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
title_fullStr Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
title_full_unstemmed Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
title_short Different interventions for OHVIRA/Herlyn-Werner-Wunderlich syndrome based on age and symptoms: a single-institution cohort study
title_sort different interventions for ohvira herlyn werner wunderlich syndrome based on age and symptoms a single institution cohort study
topic Amenorrhea
Communicating tract
Menstruation
Multicystic dysplastic kidney
Pregnancy
url https://doi.org/10.1186/s12905-025-03905-x
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