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Pediatric Hematocolpos
Published in Botros Rizk, A. Mostafa Borahay, Abdel Maguid Ramzy, Clinical Diagnosis and Management of Gynecologic Emergencies, 2020
Omar M. Abuzeid, Mostafa I. Abuzeid
Transverse vaginal septum is a rare obstructive anomaly of the vagina. It was first described by Delaunay in 1877 [23]. Its incidence was reported to vary between 1 per 7000 and 1 per 84,000 [2, 7, 8]. Although transverse vaginal septum has been described to be genetically linked with autosomal recessive inheritance, most cases of this anomaly are multifactorial in nature [24]. Transverse vaginal septum can be associated with genitourinary tract anomalies, musculoskeletal defects, gastrointestinal tract anomalies, and rarely, coarctation of the aorta and atrial septal defect [25, 26]. The transverse septum thickness varies; some are thick while others are thin in nature. Transverse vaginal septum can occur anywhere along the vaginal canal, but it is usually located in the upper or middle third of the vagina (Figure 17.2).
Long-term urologic and gynecologic follow-up in anorectal anomalies: The keys to success
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Geri Hewitt, Daniel G. DaJusta, Christina B. Ching
Patients who struggle with tampon use require a pelvic examination. Patients who report difficulty in inserting or removing a tampon often have hymenal abnormalities. This patient, however, reports the classic symptoms of a nonobstructive longitudinal vaginal septum. The tampon is being placed on only one side of the septum and menstrual egress is persisting out the other side. Examination of the vaginal introitus and/or digital vaginal exam identifies the septum (see Figure 7.7). If a patient has been using tampons, she can tolerate a pelvic exam in the office with education and support. Neither pelvic ultrasound nor MRI would identify the septum.
Congenital anomalies of the reproductive tract
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Maggie Dwiggins, Veronica Gomez-Lobo
Longitudinal vaginal septum results from a defect in canalization of any region of the vagina, but more commonly in the upper vagina near the cervix.36 This is a more common anomaly, with an incidence of about 1:1000. Patients who present with nonobstructive longitudinal vaginal septums often have presenting symptoms that may be complaints of difficulty placing a tampon or pain with intercourse; however, some may present during the course of a routine pelvic exam. Many such septums are asymptomatic and do not require treatment. It is important when there is a complete duplication that Pap smears of both cervixes be collected. When the septum is associated with discomfort, these can be resected in the operating room with Bovie cautery or the LigaSure device.42 Care must be taken to avoid deep incisions or burns in order to prevent bladder and bowel injury. Once the septum is resected, the mucosa can be approximated with absorbable suture. This surgery does not require postoperative dilation.
Validation of the Iranian version of the ENDOPAIN-4D questionnaire for measurement of painful symptoms of endometriosis
Published in Journal of Obstetrics and Gynaecology, 2022
Parivash Ahmadpour, Leila Jahangiry, Soheila Bani, Mina Iravani, Mojgan Mirghafourvand
Rokitansky first described endometriosis in 1860 (Bassi et al. 2009). Endometriosis is a chronic disease defined by the presence of endometrial stroma or gland outside of the uterus. It can affect the peritoneum, ovaries, vaginal septum, and intestines and causes a local inflammatory response. The aetiology of the disease is unknown and under discussion (Damewood et al. 1997; Vitonis et al. 2014). Estimating the prevalence of endometriosis is a difficult task. However, its prevalence among women of reproductive age is estimated to be 2% to 17% (Damewood et al. 1997; Bernuit et al. 2011). The average age of women with endometriosis in Iran is reported to be 27.5 years (Farzadi and Ghasem 2005), while in a study 30.5 years in the UK (Moses and Clark 2004) and 29.6 years in the Australian study (Dobbins et al. 2014). Endometriosis is associated with various symptoms, the majority of which are chronic pelvic pain. Its other symptoms and complications include menorrhagia, dysmenorrhoea, intermittent pelvic pain, infertility, dyspareunia, and urinary and intestinal changes during menstrual cycles (Nisolle et al. 2007). Endometriosis is both physically and emotionally debilitating. Physically, endometriosis pain can disrupt work-related and daily activities. Psychologically, endometriosis and its symptoms can lead to depression, anxiety, and low self-esteem (Low et al. 1993; Soliman et al. 2017).
MRI image features and differential diagnoses of Herlyn–Werner–Wunderlich syndrome
Published in Gynecological Endocrinology, 2020
Jinlong Zhang, Shengfang Xu, Lei Yang, Yue Songhong
The main differential diagnosis is transverse vaginal septum [24–27]. This is caused by abnormal vertical fusion of the gyneduct, and the incidence of transverse septum in congenital vaginal dysplasia is very low. The transverse septum can be incomplete or complete; an imperforated vaginal septum is termed a complete translucent, and a septum with a small hole is termed an incomplete septum. The clinical manifestations are similar to those of congenital vaginal atresia. The thickness of the diaphragm varies and is usually less than 1 cm. A transverse vaginal septum can occur at any area of the vagina, with the upper part being the most common, typically without other genitourinary malformations. MRI normally shows the dilatation of the genital tract above the transverse septum, the expansion of the uterine cavity and the upper and middle vagina, abnormal transverse signal in the lower segment, and the low signal shadow on T2WI. The length and thickness of the transverse vaginal septum can also be measured by MRI.
Asymptomatic microperforated transverse vaginal septum
Published in Journal of Obstetrics and Gynaecology, 2022
Marilia Freixo, Elisa Soares, Maria Liz Coelho, Ana Rita Pinto, Cristina Oliveira
A 27-year-old nulliparous woman attended a gynaecological routine assessment. She had no medical or surgical relevant past. She reached menarche at the age of 14. She reported a regular menstrual cycle of 5 − 6/30 days, changing pads twice a day, and had no history of clots or dysmenorrhoea. On examination, the vagina was blind and shortened with a pin hole opening in the centre (2–3 mm) and the cervix could not be identified (Figure 1). Based on clinical examination findings, a provisional diagnosis of transverse vaginal septum was made.