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High imperforate transverse vaginal septum with vaginal cicatrisation: a surgical tribulation
  1. Jyothi Shetty1,
  2. Deeksha Pandey2 and
  3. Deepa Reddy1
  1. 1Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
  2. 2OBGYN, Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu, India
  1. Correspondence to Dr Deepa Reddy; deepa.r{at}manipal.edu

Abstract

An early adolescent girl was referred to us with cryptomenorrhoea, and pelvic pain consistent with obstructed menstruation. Originally presumed to be a case of imperforate hymen, she was referred to our centre after two failed surgical misadventures at correcting the obstruction. MRI revealed a haematometrocolpos, high transverse complete vaginal septum and an occluded vagina. She underwent a laparoscopic drainage of the collection, septal resection and a vaginoplasty with an absorbable Interceed graft. Postoperative recovery was smooth and she was sent with instructions to use a vaginal mould daily. Successful surgical treatment requires precise preoperative planning with MRI. A vaginal-assisted laparoscopic approach turned out to be advantageous in resecting the septum to a large extent due to the associated cicatrised vagina. The use of Interceed, a novel mould and harnessing system, ensured a favourable postoperative outcome by bolstering patient motivation due to its less challenging technique of use.

  • Obstetrics, gynaecology and fertility
  • Reproductive medicine

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: DR. The following authors gave final approval of the manuscript: JS and DP. Is the patient one of the authors of this manuscript? No.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.