title: Double uterus with obstructed hemivagina and ipsilateral renal agenesis: pelvic anatomic variants in 87 cases.
abstract: OBJECTIVE
  What are the anatomic variants (and their frequencies) of double uterus, obstructed hemivagina and ipsilateral renal agenesis?
  
  
  CONCLUSIONS
  Most cases examined (72.4%) were of the classic anatomic variant of the Herlyn-Werner-Wunderlich syndrome (with didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis) but the 27.6% of cases are of a rare variant of the syndrome (with uterus septum or cervical agenesis), showing relevant clinical and surgical implications.
  
  
  BACKGROUND
  The extreme variability of anatomic structures involved in this syndrome (both uterus, cervico-vaginal and renal anomalies) is well known, even if a complete and uniform analysis of all its heterogeneous presentations in a large series is lacking.
  
  
  METHODS
  This is a retrospective study with 87 patients referred to our third level referral center between 1981 and 2011.
  
  
  METHODS
  We analyzed the laparoscopic and chart records of 87 women, who referred to our institute with double uterus, unilateral cervico-vaginal obstruction and ipsilateral renal anomalies.
  
  
  RESULTS
  Sixty-three of 87 patients had the more classic variant of didelphys uterus with obstructed hemivagina; 10/87 patients had septate bicollis uterus with obstructed hemivagina; 9/87 patients had bicornuate bicollis uterus with obstructed hemivagina; 4/87 patients had didelphys uterus with unilateral cervical atresia; 1/87 patients had bicornuate uterus with one septate cervix and unilateral obstructed hemivagina.
  
  
  CONCLUSIONS
  This is a retrospective study with a long enrolling period (30 years).
  
  
  CONCLUSIONS
  New insights in the anatomic variants of this rare syndrome with their relevant surgical implications.
authors.affiliation: Department of Obstetrics and Gynecology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan 20122, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Fedele
authors.forename: F
authors.initials: F
authors.lastname: Motta
authors.forename: G
authors.initials: G
authors.lastname: Frontino
authors.forename: E
authors.initials: E
authors.lastname: Restelli
authors.forename: S
authors.initials: S
authors.lastname: Bianchi
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology; D000293:Adolescent; D000328:Adult; D002648:Child; D000013:Congenital Abnormalities / Q000473:pathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000473:pathology; D007674:Kidney Diseases / Q000150:complications / Q000151:congenital* / Q000473:pathology; D012189:Retrospective Studies; D013577:Syndrome; D014564:Urogenital Abnormalities / Q000150:complications / Q000473:pathology*; D014599:Uterus / Q000002:abnormalities* / Q000473:pathology; D014621:Vagina / Q000002:abnormalities* / Q000473:pathology
keywords: Herlyn-Werner-Wunderlich syndrome; cervical agenesis; didelphys; double uterus; obstructed hemivagina