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Transverse Vaginal Septum

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Congenital Müllerian Anomalies

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Abstract

Transverse vaginal septa are a rare type of mullerian anomaly that results from failed fusion or canalization of the vaginal plate and the caudal end of the mullerian ducts. Septa are most commonly imperforate and manifest as primary amenorrhea, abdominal pain, and hematocolpos in adolescence. Perforate septa have a more variable presentation, usually associated with the foreshortened vagina and can present in adolescence or young adulthood. Proper diagnosis is made with clinical exam and imaging, usually Magnetic Resonance Imaging (MRI). Surgical management is highly dependent on the thickness and location of the septum and includes vaginal and abdominoperineal procedures. The patients’ age, developmental level, and ability to perform postoperative dilation should be considered when exploring surgical options, since prolonged dilation is often indicated in the postoperative period. Long-term complications include vaginal stenosis and re-obstruction, which may require repeat surgery. The risk of endometriosis increases with imperforate septa that are located higher in the vagina. There is limited data available on reproductive outcomes, but vaginal births have been reported.

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References

  1. Lodi A. Contribuo clinic statistic sulle malformazione all vagina osservate nella. Clinca Obstetricia e Gynecoligia di Mmilano dal 1906–1950. Ann Ostet Ginecol. 1951;73:1246–51.

    CAS  PubMed  Google Scholar 

  2. Wenof M, Reynaih JV, Novendstern J, Castadot MJ. Transverse vaginal Septum. Obstet Gynecol. 1979;54:60–4.

    Article  CAS  PubMed  Google Scholar 

  3. Jain N, Gupta A, Kumar R, Minj A. Complete imperforate transverse vaginal septum with septate uterus: a rare anomaly. J Hum Reprod Sci. 2013;6(1):74–6.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dilbaz B, Altinbas SK, Altinbas NK, Sengul O, Dilbaz S. Concomitant imperforate hymen and transverse vaginal septum complicated with pyocolpos and abdominovaginal fistula. Case Rep Obstet Gynecol. 2014;2014:1–4.

    Article  Google Scholar 

  5. Deligeoroglou E, Deliveliotou A, Makrakis E, Creatsas G. Concurrent imperforate hymen, transverse vaginal septum, and unicornuate uterus: a case report. J Pediatr Surg. 2007;42(8):1446–8.

    Article  PubMed  Google Scholar 

  6. Ahmed S, Morris LL, Atkinson E. Distal mucocolpos and proximal hematocolpos secondary to concurrent imperforate hymen and transverse vaginal septum. J Pediatr Surg. 1999;34(10):1555–6.

    Article  CAS  PubMed  Google Scholar 

  7. Wierrani F, Bodner K, Spangler B, Grunberger W. “Z”-plasty of the transverse vaginal septum using Garcia’s procedure and the Grunberger modification. Fertil Steril. 2003;79(3):608–12.

    Article  PubMed  Google Scholar 

  8. Laufer MR. Structural abnormalities of the female reproductive tract. In: Emans SJ, Laufer MR, editors. Emans, Laufer, Goldstein’s pediatric and adolescent gynecology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2012. p. 188–236.

    Google Scholar 

  9. Grimbizis GF, Gordts S, Di Seizio SA, Brucker S, De Angelis C, Gergolet M, et al. The ESHRE/ESGE consensus on the classification of female genital tract congenital anomalies. Hum Reprod. 2013;28(8):2032–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Grimbizis GF, Campo R. Congenital malformations of the female genital tract: the need for a new classification system. Fertil Steril. 2010;94(2):401–7.

    Article  PubMed  Google Scholar 

  11. Acien P, Acien MI. The history of female genital tract malformation classifications and proposal of an updated system. Hum Reprod Update. 2011;17(5):693–705.

    Article  PubMed  Google Scholar 

  12. Oppelt P, Renner SP, Brucker S, Strissel PL, Strick R, Oppelt PG, et al. The VCUAM (Vagina Cervix Uterus Adnex-associated Malformation) classification: a new classification for genital malformations. Fertil Steril. 2005;85(5):1493–7.

    Article  Google Scholar 

  13. Williams CE, Nakhal RS, Hall-Craggs MA, Wood D, Cutner A, Pattison SH, Creighton SM. Transverse vaginal septae: management and long term outcomes. BJOG. 2014;121:1653–9.

    Article  CAS  PubMed  Google Scholar 

  14. Levy G, Warren M, Maidman J. Transverse vaginal septum: case report and review of the literature. Int Urogynecol J Pelvic Floor Dysfunct. 1997;8:173–6.

    Article  CAS  PubMed  Google Scholar 

  15. Banerjee R, Laufer MR. Reproductive disorders associated with pelvic pain. Semin Pediatr Surg. 1998;7(1):52–61.

    Article  CAS  PubMed  Google Scholar 

  16. Breech LL, Laufer MR. Mullerian anomalies. Obstet Gynecol Clin North Am. 2009;36:47–68.

    Article  PubMed  Google Scholar 

  17. Dietrich JE, Miller DM, Quint EH. Obstructive reproductive tract anomalies. J Pediatr Adolesc Gynecol. 2014;27:396–402.

    Article  PubMed  Google Scholar 

  18. Rock JA. Anomalous development of the vagina. Semin Rerpod Endocrinol. 1986;4:13–31.

    Article  Google Scholar 

  19. Suidan FG, Azoury FS. The transverse vaginal septum: a clinicopathologic evaluation. Obstet Gynecol. 1979;54(3):278–83.

    CAS  PubMed  Google Scholar 

  20. Simpson JL. Genetics of the female reproductive ducts. Am J Med Genet. 1999;89:224–39.

    Article  CAS  PubMed  Google Scholar 

  21. Slavotinek AM. Mckusick-Kaufman syndrome. Gene Review. http://www.ncbi.nlm.nih.gov/books/NBK1502/. Accessed 29 June 2010.

  22. Ameh EA, Mshelbwala PM, Ameh N. Congenital vaginal obstruction in neonates and infants: recognition and management. J Pediatr Adolesc Gynecol. 2011;24:74–8.

    Article  PubMed  Google Scholar 

  23. Rock JA, Brrech LL. Surgery for anomalies of the mullerian ducts. In: Rock JA, Jones HW, editors. Telinde’s operative gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 539–84.

    Google Scholar 

  24. Attaran M, Falcone T, Gidwani G. Obstructive mullerian anomalies. In: Gidwani G, Falcone T, editors. Congenital malformations of the female genital tract. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 145–68.

    Google Scholar 

  25. Rock JA, Azziz R. Genital anomalies in Childhood. Clin Obstet Gynecol. 1987;30(3):682–96.

    Article  CAS  PubMed  Google Scholar 

  26. Kaya C, Cengiz H, Ekin M, Yasar L. Transverse vaginal septum: a benign reason for elevated serum CA19-9 and CA 125 levels. Arch Gynecol Obstet. 2012;286:821–3.

    Article  PubMed  Google Scholar 

  27. Bermejo C, Martinez-Ten P, Recio M, Ruiz-Lopez L, Diaz D, Illescas T. Three-dimensional ultrasound and magnetic resonance imaging assessment of cervix and vagina in women with uterine malformations. Ultrasound Obstet Gynecol. 2014;43:336–45.

    Article  CAS  PubMed  Google Scholar 

  28. Krafft C, Hartin CW, Ozgediz DE. Magnetic resonance as an aid in the diagnosis of a transverse vaginal septum. J Pediatr Surg. 2012;47:422–5.

    Article  PubMed  Google Scholar 

  29. Church DG, Vancil JM, Vasanawala S. Magnetic resonance imaging for uterine and vaginal anomalies. Curr Opin Obstet Gynecol. 2009;21:379–89.

    Article  PubMed  Google Scholar 

  30. Olpin JD, Heilbrun M. Imaging of mullerian duct anomalies. Clin Obstet Gynecol. 2009;52(1):40–56.

    Article  PubMed  Google Scholar 

  31. Humphries PD, Simpson JC, Creighton SM, Hall-Craggs MA. MRI assessment of congenital vaginal anomalies. Clin Radiol. 2008;63:442–8.

    Article  CAS  PubMed  Google Scholar 

  32. Brown MA, Mattrey RF, Stamato S, Sirlin CB. MRI of the female pelvis using vaginal gel. AJR Am J Roentgenol. 2005;185:1221–7.

    Article  PubMed  Google Scholar 

  33. Lang IM, Babyn P, Oliver GD. MR imaging of paediatric uterovaginal anomalies. Pediatr Radiol. 1999;29:163–70.

    Article  CAS  PubMed  Google Scholar 

  34. Quint EH, McCarthy JD, Smith YR. Vaginal surgery for congenital anomalies. Clin Obstet Gynecol. 2010;53(1):115–24.

    Article  PubMed  Google Scholar 

  35. Van Bijsterveldt C, Willemsen W. Treatment of patients with congenital transversal vaginal septum or partial aplasia of the vagina. The vaginal pull-through versus the push-through technique. J Pediatr Adolesc Gynecol. 2009;22:157–61.

    Article  PubMed  Google Scholar 

  36. Bush NC, Prieto JC, Baker LA. Vaginoplasty in children using autologous buccal mucosa. J Urol. 2008;179(4):94.

    Article  Google Scholar 

  37. Yesim Ozgenel G, Ozcan M. Neo vaginal construction with buccal mucosal grafts. Plast Reconstr Surg. 2003;111:2250–4.

    Article  PubMed  Google Scholar 

  38. Raya-Rivera AM, Esquiliano D, Fierro-Pastrana R, Lopez Bayghen E, Valencia P, Ordorica-Flores R, et al. Tissue-engineered autologous vaginal organs in patients: a pilot cohort study. Lancet. 2014;384:329–36.

    Article  PubMed  Google Scholar 

  39. Lacy J, Correll GR, Walmer DK, Price TM. Simple vaginal mold for use in the postoperative care of patients with transverse vaginal septum. Fertil Steril. 2007;87(5):1225–6.

    Article  PubMed  Google Scholar 

  40. Hurst BS, Rock JA. Preoperative dilation to facilitate repair of the high transverse vaginal septum. Fertil Steril. 1992;57(6):1351–3.

    Article  CAS  PubMed  Google Scholar 

  41. Mizia K, Bennett MJ, Dudley J, Morrisey J. Mullerian dysgenesis: a review of recent outcomes at Royal Hospital for Women. Aust N Z J Obstet Gynaecol. 2006;46:29–31.

    Article  PubMed  Google Scholar 

  42. Dennie J, Pillay S, Watson D, Grover S. Laparoscopic drainage of hematocolpos: a new treatment option for the acute management of a transverse septum. Fertil Steril. 2010;94(5):1853–7.

    Article  PubMed  Google Scholar 

  43. Miller RJ, Breech LL. Surgical correction of vaginal anomalies. Clin Obstet Gynecol. 2008;52(2):223–36.

    Article  Google Scholar 

  44. Beyth Y, Klein Z, Weinstein S, Tepper R. Thick transverse vaginal septum: expectant management followed by surgery. J Pediatr Adolesc Gynecol. 2004;17:373–81.

    Article  Google Scholar 

  45. Burgis J. Obstructive mullerian anomalies: case report, diagnosis, and management. Am J Obstet Gynecol. 2001;185(2):338–44.

    Article  CAS  PubMed  Google Scholar 

  46. Rock JA, Zacur HA, Dlugi AM, Jones HW, TeLinde RW. Pregnancy success following surgical correction of imperforate hymen and complete transverse vaginal septum. Obstet Gynecol. 1982;59(4):448–51.

    CAS  PubMed  Google Scholar 

  47. Malhotra V, Bhuria V, Nanda S, Chauhan MB, Dahiya P. Transverse vaginal septum in labor. J Gynecol Surg. 2013;29(4):207–9.

    Article  Google Scholar 

  48. Blanton EN, Rouse DJ. Trial of labor in women with transverse vaginal septa. Obstet Gynecol. 2003;101(5):1110–2.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Michigan Health System, 1500 E Medical Center Drive, SPC 5276, Ann Arbor, MI, 48109, USA

    Veronica I. Alaniz M.D., M.P.H. & Elisabeth H. Quint M.D.

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  1. Veronica I. Alaniz M.D., M.P.H.
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  2. Elisabeth H. Quint M.D.
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Correspondence to Elisabeth H. Quint M.D. .

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  1. Weill Cornell Medical College, New York, New York, USA

    Samantha M. Pfeifer

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Alaniz, V.I., Quint, E.H. (2016). Transverse Vaginal Septum. In: Pfeifer, S. (eds) Congenital Müllerian Anomalies. Springer, Cham. https://doi.org/10.1007/978-3-319-27231-3_4

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  • DOI: https://doi.org/10.1007/978-3-319-27231-3_4

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