URETEROPELVIC JUNCTION OBSTRUCTION IN PATIENTS WITH HERLYN-WERNER-WUNDERLICH SYNDROME: A CLINICAL CASE REPORT

Nữ Vương Nguyễn Trần1, , Viet Cuong Nguyen1, Thuong Truong Minh1, Tu Anh Dang Thanh1
1 Bệnh viện Quân y 175

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Abstract

Objectives: To report a case of ureteropelvic junction obstruction (UPJO) in a solitary kidney in a patient with Herlyn-Werner-Wunderlich (HWW) syndrome. Methods: This study presents a rare case of hydronephrosis caused by UPJO due to crossing renal vessels, occurring concurrently with HWW syndrome at Military Hospital 175 from June 25 to July 24, 2024. Results: Contrast-enhanced computed tomography (CT) identified the obstruction caused by crossing vessels at the UPJ. The diagnosis of HWW was confirmed by magnetic resonance imaging (MRI). The patient underwent successful renal function-preserving treatment with retroperitoneal laparoscopic pyeloplasty and ureteral transposition. Conclusion: This case highlights the importance of early identification of the underlying cause of hydronephrosis in patients with a solitary kidney, such as those with HWW syndrome. Imaging modalities, especially contrast-enhanced CT, are valuable for detecting associated vascular anomalies.

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References

1. V Ellerkamp, RR Kurth, E Schmid, S Zundel, SW Warmann, and J Fuchs. Differences between intrinsic and extrinsic ureteropelvic junction obstruction related to crossing vessels: Histology and functional analyses. World J. Urol. Apr. 2016; 34(4):577-583. Doi: 10.1007/s00345-015-1645-x.
2. NJO’ Sullivan and S Anderson. Pelviureteric junction obstruction in adults: A systematic review of the literature. Curr. Urol. Jun. 2023; 17(2):86-91. DOI: 10.1097/CU9.0000000000000154.
3. M Elmussareh, O Traxer, BK Somani, and CS Biyani. Laser endopyelotomy in the management of pelviureteric junction obstruction in adults: A systematic review of the literature. Urology. Sep 2017; 107:11-22. DOI: 10.1016/j.urology.2017.04.018.
4. A David, SN Gudi, and R Shankar. Herlyn-Werner-Wunderlich Syndrome: Premenarche. J. South Asian Fed. Obstet. Gynaecol. 2017; 9(2):207-210, DOI: 10.5005/jp-journals-10006-1496.
5. B Schlomer, E Rodriguez, and L Baskin. Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome should be redefined as ipsilateral renal anomalies: Cases of symptomatic atrophic and dysplastic kidney with ectopic ureter to obstructed hemivagina. J. Pediatr. Urol. Apr. 2015; 11(2):77.e1-6. DOI: 10.1016/ j.jpurol.2014.12.004.
6. LP Lawler, TW Jarret, FM Corl, and EK Fishman. Adult ureteropelvic junction obstruction: Insights with three-dimensional multi-detector row CT. RadioGraphics. Jan 2005; 25(1):121-134. DOI: 10.1148/rg.251045510.
7. A Rai, A Hsieh, and A Smith. Contemporary diagnosis and management of pelvi-ureteric junction obstruction. BJU Int. Sep 2022; 130(3):285-290. DOI: 10.1111/bju.15689.
8. M Grasso, RP Caruso, and CK Phillips. UPJ obstruction in the adult population: Are crossing vessels significant? Rev. Urol. 2001; 3:(1):42-51.
9. C Xie, X Chen, Y Li, Y He, and B Zhang. Application of three-dimensional visualization technology in laparoscopic pyeloplasty for ureteropelvic junction obstruction caused by crossing vessels: A retrospective comparative cohort study. Transl. Androl. Urol. Dec 2022; 11(12):1706-1714. DOI: 10.21037/tau-22-695.
10. MS Al Aaraj and AM Badreldin. Ureteropelvic junction obstruction in StatPearls, Treasure Island (FL): StatPearls Publishing, 2025. Accessed: Jul. 03, 2025. [Online]. Available: http://www.ncbi.nlm.nih.gov/books/NBK560740/