Successful term pregnancy post laparoscopic management of thick perforate upper transverse vaginal septum

Authors

  • Manjula Anagani Department of Obstetrics and Gynecology, Maxcure Suyosha Women and Child Hospital, Hyderabad, Telangana, India
  • Prabha Agrawal Department of Obstetrics and Gynecology, Maxcure Suyosha Women and Child Hospital, Hyderabad, Telangana, India
  • B. Radhika Department of Obstetrics and Gynecology, Maxcure Suyosha Women and Child Hospital, Hyderabad, Telangana, India
  • Amodita Ahuja Department of Obstetrics and Gynecology, Maxcure Suyosha Women and Child Hospital, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20183363

Keywords:

Complex congenital malformation, Dyspareunia, Infertility, Transverse vaginal septum

Abstract

A 30-year-old woman presented with dyspareunia and infertility and was referred to after failure to visualize cervix during diagnostic laparoscopy by her primary consultant. Preoperative MRI was done which showed mild arcuate uterus with minimum fluid in vaginal cavity with vertical vaginal septum. This was managed successfully by a combined laparoscopic and vaginal approach. She conceived spontaneously and delivered a healthy term baby by caesarean section. Upper thick Transverse Vaginal Septum is a complex congenital malformation posing challenges for its correction, restoring normal healthy sex life and conception. The septum varies in thickness and may be located anywhere along the vagina reducing the functional length of the vagina.  Identifying and dissecting the anatomic structures is greatly aided by panoramic view of laparoscope allowing the surgeon to have an increased degree of freedom during surgery.

References

Sharma R, Weerakkody Y. Transverse vaginal septum. Radiopedia. System: Paediatrics, Gynaecology. Section: Anatomy. Revision 17, rID: 15382. Available at: https://radiopaedia.org/articles/transverse-vaginal-septum

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

Gupta R, Bozzay JD, Williams DL, DePond RT, Gantt PA. Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision. Case Reports Obstet Gynecol. 2015;2015.

Pushkar P, Rawat SK, Chowdhary SK. Robotic approach to vaginal atresia repair in an adolescent girl. Urol Annals. 2015 Jul;7(3):396.

Williams CE, Nakhal RS, Hall‐Craggs MA, Wood D, Cutner A, Pattison SH, et al. Transverse vaginal septae: management and long‐term outcomes. BJOG: An Int J Obstet Gynaecol. 2014 Dec;121(13):1653-8.

Giannesi A, Marchiole P, Benchaib M, Chevret-Measson M, Mathevet P, Dargent D. Sexuality after laparoscopic Davydov in patients affected by congenital complete vaginal agenesis associated with uterine agenesis or hypoplasia. Human Reprod. 2005 Jun 24;20(10):2954-7.

Caloia DV, Morris H, Rahmani MR. Congenital transverse vaginal septum: vaginal hydrosonographic diagnosis. J Ultrasound Med. 1998 Apr;17(4):261-4.

Delaunay JV. Etude sur le cloisonnement transversal du vagin complet et incomplete d'origine congenital. Thesis, Paris. 1877.

Reed MH, Griscom NT. Hydrometrocolpos in infancy. AJR. 1973;118:1.

Ara S, Tahir S. Diagnosis and management of congenital anomalies of vagina. APMC. 2011;5:124.

Ammann AM, Brewer WH, Hurt WG. A high transverse vaginal septum: sonographic findings. J Ultrasound Med. 1983 Oct;2(10):471-2.

Meyers RL. Congenital anomalies of the vagina and their reconstruction. Clin Obstet Gynaecol. 1997;40:168-80.

Tiwari C, Shah H, Singhavi S. Low complete transverse vaginal septum, vesico-ureteric reflux and low anorectal malformation: Case report and review of literature. Int J Ped Adol Med. 2016 Jun 1;3(2):81-4.

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Published

2018-07-26

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Section

Case Reports