Management of a Transverse Upper Vaginal Septum with Hematometrocolpos: A Case Report

Abstract

The transverse vaginal septum is a rare congenital anomaly of the female genital tract caused by defective fusion or canalization of the urogenital sinus and Müllerian ducts. It can result in complete vaginal obstruction, leading to haematometrocolpos and cyclic pelvic pain, typically emerging after menarche in adolescents. Diagnosis involves thorough clinical examination and imaging like 3D ultrasound or MRI for complex cases. Early surgical treatment is crucial to ensure effective management and avoid complications.

We report the case of a 14-year-old female treated for hematometrocolpos secondary to a complete transverse vaginal septum. A laparoscopic approach was used, involving a vertical incision in the cervix and upper vagina to drain the hematometrocolpos, exposing the upper septum. The septum was elevated, incised transversely, and extended laterally, with the edges sutured using 2-0 Polyglactin in a simple interrupted pattern. Postoperatively, a vaginal mold with an amnion graft was placed to prevent stenosis and removed three days later.