Transvaginal Excision of Transverse Vaginal Septum in Children

Abstract

Congenital anomalies of the female genital tract are often asymptomatic and therefore unrecognized. They usually present at adolescent with abdominal pain at the time of menarche. This is a report of two teen aged girls who presented to the University Hospital-Sharjah (UHS) complaining of recurrent attacks of cyclical lower abdominal pain which comes within the premenstrual periods and fades after menses. They were investigated and managed in other hospitals with no improvement. The two patients were diagnosed by trans-abdominal and trans-perineal pelvic U/S in addition to MRI studies which confirmed the diagnosis of didelphys uterus with an obstructing transverse vaginal septum leading to hematocolpos and hematometrocolpos in addition to the presence of an ipsilateral renal agenesis. Per-operative hysteroscopy was valuable in identification of the abnormal anatomy. The technique of transvaginal surgical excision of the septum in both cases with attempt to preserve the hymen in addition to the problems in diagnosis and management of these rare anomalies are discussed.