{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:12:40Z","timestamp":1788415960847,"version":"build-2803163510"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Herlyn\u2013Werner\u2013Wunderlich syndrome (HWWS) management typically requires hymenotomy. We describe the fully endoscopic, hymen-sparing septotomy in a patient with no history of sexual intercourse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 20-year-old patient with no prior sexual intercourse and progressive dysmenorrhea was diagnosed by MRI with HWWS, presenting as uterus didelphys, obstructed right hemivagina, and left renal agenesis. A 9-mm flexible gastroscope and endoscopic submucosal dissection (ESD) knives were introduced through the intact hymen to resect an 11\u202f\u00d7\u202f13\u202fmm oblique septum, evacuating 20\u202fmL of chocolate fluid. The hymen remained intact. The patient was discharged on postoperative day 3 and remained asymptomatic at 2-month follow-up, with no residual hematocolpos detected on ultrasound. Telephone follow-up at 12 and 18\u202fmonths postoperatively confirmed no recurrence of dysmenorrhea.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Endoscopic septotomy safely relieves HWWS obstruction while preserving hymenal integrity in patients with no sexual history. This novel technique addresses a crucial patient-centered need and expands therapeutic options for complex M\u00fcllerian anomalies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1771221","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:15:18Z","timestamp":1788412518000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Soft endoscopic treatment of Herlyn\u2013Werner\u2013Wunderlich syndrome: an innovative clinical procedure for hymen preservation"],"prefix":"10.3389","volume":"13","author":[{"given":"Yonghua","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, 923th Hospital of PLA Joint Logistics Support Force","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 925th Hospital of PLA Joint Logistics Support Force","place":["Guiyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Geng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, 923th Hospital of PLA Joint Logistics Support Force","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.31729\/jnma.8096","article-title":"Herlyn-Werner-Wunderlich syndrome: a case report","volume":"61","author":"Vaidya","year":"2023","journal-title":"JNMA J Nepal Med Assoc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e35003","DOI":"10.7759\/cureus.35003","article-title":"Herlyn\u2013Werner\u2013Wunderlich syndrome: a rare case report","volume":"15","author":"Habbash","year":"2023","journal-title":"Cureus"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"7173","DOI":"10.3390\/ijerph17197173","article-title":"Herlyn\u2013Werner\u2013Wunderlich syndrome: comparison of two cases","volume":"17","author":"Koz\u0142owski","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1016\/j.tjog.2024.10.017","article-title":"Herlyn Werner Wunderlich syndrome. 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Gynecol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1055\/a-1127-3304","article-title":"Peroral endoscopic septotomy for short-septum Zenker's diverticulum","volume":"52","author":"Repici","year":"2020","journal-title":"Endoscopy"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1990","DOI":"10.1007\/s00464-020-07593-6","article-title":"Peroral endoscopic myotomy for the treatment of esophageal diverticulum: an experience in China","volume":"35","author":"Zeng","year":"2021","journal-title":"Surg Endosc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/j.jmig.2023.01.019","article-title":"Vaginoscopic resection of oblique vaginal septum in OHVIRA syndrome before menarche","volume":"30","author":"Kulkarni","year":"2023","journal-title":"J Minim Invasive Gynecol"},{"key":"ref14","first-page":"83","article-title":"Obstructed hemivagina and ipsilateral renal anomaly syndrome in an association with endometriosis: role of magnetic resonance imaging in diagnosis","volume":"79","author":"Choridah","year":"2024","journal-title":"Med J Malaysia"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.radcr.2023.09.030","article-title":"Herlyn\u2013Werner\u2013Wunderlich syndrome in a young female presenting with dysmenorrhea: a case report","volume":"19","author":"Dahal","year":"2024","journal-title":"Radiol Case Rep"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e30450","DOI":"10.7759\/cureus.30450","article-title":"Vaginoscopic incision of vaginal septum with preservation of the hymen in a child with obstructed hemi-vagina ipsilateral renal agenesis (OHVIRA) syndrome","volume":"14","author":"Moneir","year":"2022","journal-title":"Cureus"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e223","DOI":"10.52225\/narra.v3i2.223","article-title":"Herlyn\u2013Werner\u2013Wunderlich syndrome: Challenges in diagnosis and 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