Barut A, Hirsi ZA, Yusuf K. Management of an isolated complete imperforate transverse vaginal septum: A case report.
Int J Surg Case Rep 2022;
100:107744. [PMID:
36265424 PMCID:
PMC9579800 DOI:
10.1016/j.ijscr.2022.107744]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction and importance
The isolated complete transverse vaginal septum (TVS) is a rare congenital abnormality. Which can completely obstructed the vagina, can cause a hematometrocolpos associated with cyclic severe pelvic pain and primary amenorrhea. Management of this case was discussed.
Case presentation
A 14-year-old adelocant girl with primary amenorrhea and severe persistent pelvic pain presented to the gynecology outpatient clinic in our hospital. On pelvic examination, there did not see cervical external os. Radiologic imaging revealed a markedly both fluid intrauterine cavity and upper vaginal canal. The patient underwent general anesthesia, a partial incision of the septum was performed. At discharged time sponge soaked with estrogen cream and 22 number catheter were placed in her vagina to prevent stenosis.
Clinical discussion
Transverse vaginal septum is no symptoms until the age of menarche, and can cause recurrent pelvic pain and amenorrhea. The patient underwent general anesthesia, underwent the partial incision of the septum. Then with end-to-end suturing of the remained vaginal edges, and put urinary 22 number catheter inside the upper vagina for preventing stenosis of the vagina in an operating room.
Conclusion
The excision of septum have put catheter for 3 months with estradiol cream to prevent stenosis and failure of the operation. The management can be performed in the transverse vaginal septum, without any complications. This report gave an option in a simple and effective method that allows the gynecologist to treat this case to reach a good result and still needed to follow up in the future.
Haematometrocolpos due to a transverse vaginal septum or imperforate hymen can be a cause of abdominal pain and distension in a young woman.
A high index of suspicion is needed to diagnose transverse vaginal septum as the cause of the abdominal pain and late onset of menarche.
Radiologic imagings are useful during diagnosis and help with locating and measuring the septum for further surgical correction.
The excision of septum have put catheter for 3 months with estradiol cream to prevent stenosis and failure of the operation.
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