Excision of high vaginal septum

Transverse vaginal septum occurs because there is a defect in vertical fusion during embryological development of the vagina. It is quite rare and is infrequently encountered by most obstetricians and gynecologists in their practice.

A 14-year-old unmarried student, Miss AUX, presented to a private gynecologist complaining of absent menses. Initial examination and investigation revealed intact hymen, normal uterus but no hematometra/hematocolpos. She was commenced on combined oral contraceptives [Yasmin] by the gynecologist. On December 14, 2007, she presented to Maternity hospital with a 6-months history of monthly cyclical abdominal pain with no menses. Physical examination and ultrasonography revealed a high transverse vaginal septum with hemotometra but no hematocolpos. Excision of the septum was performed under ultrasound guidance. The post operative period was uneventful. Normal menses were reported by the patient during outpatient follow-up.

The excision of a high transverse vaginal septum in a 14-year-old unmarried student, presented with cyclical abdominal pain and absent menses and confirmed to have hematometra, was followed by a return of regular menstruation.