Herlyn–Werner–Wunderlich syndrome in an adolescent with epilepsy: Diagnostic and surgical challenges-first case report from Palestine

Herlyn–Werner–Wunderlich syndrome is a rare congenital Müllerian duct anomaly characterized by uterine duplication, obstructed hemivagina, and ipsilateral renal agenesis, and it should be considered in adolescents presenting with severe cyclical pelvic pain. We report the case of a 14-year-old female who presented with 6 months of progressively worsening dysmenorrhea and pelvic pain; imaging studies revealed uterus didelphys with an obstructed right hemivagina, a posterior pelvic collection, and right renal agenesis. The patient underwent transvaginal septal excision with evacuation of hematocolpos, resulting in rapid symptom resolution and restoration of normal menstrual outflow. This case highlights the importance of early recognition, appropriate multimodal imaging, and timely surgical management to prevent complications and preserve reproductive potential, while noting that comorbid conditions such as epilepsy require perioperative consideration even when they do not alter the surgical approach.