Late diagnosis of müllerian duct anomalies in women: reproductive losses and surgical errors, experience in managing patients with Herlyn–Werner–Wunderlich syndrome

One in ten women worldwide (285–400 million people) lives with a genitourinary malformation. Urogenital anomalies often remain undetected, despite the advanced 21st century medical technologies. As a result, many of these women undergo infertility treatment without being aware of the true underlying cause of their condition. Using two clinical cases from the authors’ own experience in the management of reproductive-age patients with Müllerian duct anomalies, this article provides a detailed analysis of why timely detection of genitourinary malformations is critically important. In the first clinical case, the patient had an untimely diagnosis of Herlyn–Werner–Wunderlich syndrome, which likely resulted in a series of unnecessary surgical interventions and subsequent complications. In the second clinical case, the patient was diagnosed with a bicornuate uterus, incomplete vaginal duplication, and partial aplasia of the left vagina, which may have been the cause of many years of infertility. In both cases, the patients underwent surgical treatment aimed at creating an artificial perforation of the previously obstructed vagina, thereby enabling free menstrual drainage. Surgical management reduced the risk of complications associated with the development of hematocolpos, hematometra, and hematocervix, and significantly improved the patients’ quality of life. Expert and timely diagnosis, rational surgical management, and a high level of professional expertise enabled these patients to achieve their reproductive goals.