Diagnosis and Treatment in a Tertiary Hospital of a Series of Complex Genital Malformations Corresponding to Double Uterus with Obstructed Hemivagina and Ipsilateral Renal Agenesis

Table 1

Description of the 14 cases of diagnosed HWWS.

Case	Age at 1st visit	Clinical signs and symptoms	Diagnosis	Treatment	Pregnancy
1	11	Progressively worsening dysmenorrhea persisting after the end of the menstrual flow	Uterus didelphys, complete transverse vaginal septum, R renal agenesis, R hematometra	Exeresis of the vaginal septum with discharge of chocolate brown blood	G1P1A0 (preterm pregnancy at 17 years)
2	13	Irregular cycles accompanied by dysmenorrhea since menarche	Uterus didelphys, complete transverse vaginal septum, R renal agenesis, R hematocolpos	Exeresis of the vaginal septum and drainage of hematocolpos	G0
3	24	Purulent and constant vaginal secretion	Uterus didelphys, transverse vaginal septum, R renal agenesis, purulent secretion	Resection of the transverse vaginal septum on the right and abscess drainage	G0
4	14	Irregular cycles with severe dysmenorrhea and difficulty urinating	Uterus didelphys, transverse vaginal septum, L renal agenesis, L hematometra	Resection of the vaginal septum, drainage of hematometra and L salpingectomy	G0
5	23	Daily bleeding associated with chronic pelvic pain of moderate intensity and dysmenorrhea	Uterus didelphys, transverse vaginal septum, L renal agenesis hematometra	Resection of the vaginal septum, drainage of hematometra and L salpingectomy	G0
6	13	Progressive dysmenorrhea since menarche	Uterus didelphys, transverse vaginal septum, R renal agenesis, hematocolpos (dilated cervix, body and right uterine tube)	Opening of the vaginal septum, drainage of hematocolpos and total abdominal hysterectomy 3 months after septum exeresis	G0
7	11	Progressively worsening dysmenorrhea persisting after the end of the menstrual flow	Uterus didelphys, transverse vaginal septum, L renal agenesis, hematocolpos, hematosalpinx	Exeresis of the vaginal septum, drainage of hematocolpos and salpingectomy	G0
8	12	Continuous pain in the hypogastrium arising with the menstrual flow	Uterus didelphys, transverse vaginal septum, L renal agenesis, hematocolpos	Exeresis of the vaginal septum, drainage of hematocolpos, oophorectomy and salpingectomy	G0
9	13	Progressive dysmenorrhea	Uterus didelphys, transverse vaginal septum, R renal agenesis, hydrosalpinx	Exeresis of R rudimentary horn and pyosalpinx	G0
10	13	Extensive vaginal bleeding and pelvic pain in inguinal regions	Uterus didelphys, transverse vaginal septum, R renal and ureteral agenesis	Exeresis of the vaginal septum	G0
11	29	Constant and progressive pain in a hypogastric region during the perimenstrual period	Uterus didelphys, transverse vaginal septum, R renal agenesis, hematocolpos, pelvic endometriosis	Exeresis of the vaginal septum and drainage of hematocolpos	G1P1A0; (cesarean delivery of a preterm liveborn at 35 weeks)
12	13	Increased menstrual flow since menarche	Uterus didelphys, transverse vaginal septum, L renal agenesis, presence of purulent content	Exeresis of the vaginal septum	G0
13	16	Vaginal discharge, blood clots after menstruation and intense menstrual cramps	Uterus didelphys, transverse vaginal septum, R renal agenesis, R hydrosalpinx	Exeresis of the vaginal septum	G4P3A1
14	21	Progressive dysmenorrhea and severe pelvic endometriosis	Uterus didelphys, transverse vaginal septum, R renal agenesis	Exeresis of the vaginal septum	G0