Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision

Gupta, Ridhima; Bozzay, Joseph; Williams, David; DePond, Robert T.; Gantt, Pickens A.

doi:10.1155/2015/975463

Cited by 13 publications

(28 citation statements)

References 6 publications

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“…Ridhima Gupta et al presented a case of 15 year old girl with unicornuate uterus and transverse vaginal septum (TVS). [8] The TVS was excised, however patient was unable to perform vaginal dilation post operatively, leading to stricture formation. She underwent multiple surgeries for excision of the stricture.…”

Section: Resultsmentioning

confidence: 99%

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Agarwal¹,

Pyrbot²,

Shullai³

2018

AIMDR

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Background: To analyse the clinical features, diagnostic challenge and treatment options in patients presenting with pain abdomen and cryptomenorrhea in patients with vaginal obstructive lesions in comparison with those having normal vagina but having non communicating rudimentary horn with functional endometrium. Methods: The clinical details of patients presenting with cryptomenorrhea to our institute was studied. The data collected was from a period of 7 years; from March 2010 to April 2017. The clinical details were collected from cases sheets of the respective cases. Result: A total of 6 cases were studied. Among the 6 patients, all were within the age group of 13-20 years. 3 patients had abnormality in the form of vaginal agenesis, transverse vaginal septum and imperforate hymen. All the 3 presented with amenorrhea and severe cyclical pain. The other 3 patients had rudimentary non communicating horn with functional endometrium and had different clinical presentations. One had severe dysmenorrhoea, one had severe cyclical pain with amenorrhea and the third patient had been operated earlier and presented with severe dysmenorrhoea with an incision site sinus with discharge of menstrual blood abdominally along with vaginal passage of menses. Since reflux of menstrual blood is seen in all cases, endometriotic ovary was found in 2 cases. One had only hematosalpinx. Two patients have been operated earlier for endometriotic cyst but the abnormality in the uterus or vagina was not detected, leading to reoccurrence of symptoms. Conclusion: Cryptomenorrhea or hidden menses due to congenital malformation in the uterus or vagina is a rare condition but can lead to distressing symptoms of dysmenorrhoea in young girls. It can also cause endometriosis due to retrograde menstruation .Improper evaluation can miss the proper diagnosis and patient may be operated only for endometriosis of ovary as a cause for dysmenorrhoea. Not identifying and treating the primary abnormality will lead to recurrence of symptoms and repeat surgeries in patients.

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Section: Resultsmentioning

confidence: 99%

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Agarwal¹,

Pyrbot²,

Shullai³

2018

AIMDR

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“…It is believed to arise from a failure in fusion or canalization (or both) of the urogenital sinus and Müllerian ducts. The cause is unknown although some cases might be the result of a female sex-limited autosomal recessive transmission [1] or exposure to certain agents in utero [5]. The septum is composed of fibrous connective tissue and vascular muscular elements.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of a TVS is individualized, and the goal is to relieve cyclic abdominal pain and prevent development of endometriosis to preserve fertility [5], [8], [9]. Vaginal dilators are the preferred non-surgical choice for patients with small septa [5].…”

Section: Discussionmentioning

confidence: 99%

Low complete transverse vaginal septum, vesico-ureteric reflux and low anorectal malformation

Tiwari¹,

Shah²,

Singhavi³

2016

International Journal of Pediatrics and Adolescent Medicine

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The complete, imperforate transverse vaginal septum is one of the rare anomalies of the female reproductive tract. This anomaly is a disorder of vertical fusion of the Müllerian ducts and can present with or without obstruction. It has been classified as Type IIA as per the American Fertility Society (AFS) classification. Its thickness and site varies in the vaginal canal; the upper and middle third septa are common. The diagnosis can be made in newborns, infants, and adolescent girls. It is found associated with urological anomalies, anorectal malformation (ARM), and bicornuate uterus. We present a case of a 13-year-old girl with hematometrocolpos due to an imperforate complete low vaginal septum, left-sided vesico-ureteric reflux (VUR), and ectopic anus (low ARM).

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“…2 A vaginal septum is caused by incomplete fusion of the separating tissue between the fused Mullerian ducts and the vaginal plate. 3 The majority of vaginal septa are located in the upper and middle third of the vagina; and thicker septa usually are closer to the cervix. 3 TVS differs from vaginal agenesis in that the Mullerian structures are usually not affected.…”

Section: Introductionmentioning

confidence: 99%

“…3 The majority of vaginal septa are located in the upper and middle third of the vagina; and thicker septa usually are closer to the cervix. 3 TVS differs from vaginal agenesis in that the Mullerian structures are usually not affected. 4 Septae can be perforate or imperforate and vary in their thickness and location in the vagina.…”

Section: Introductionmentioning

confidence: 99%

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

Anagani¹,

Agrawal²,

Radhika³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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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.

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Management of Recurrent Stricture Formation after Transverse Vaginal Septum Excision

Cited by 13 publications

References 6 publications

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

A Comparative Analysis of Cryptomenorrhea in Patients with Vaginal Obstruction Vis a Vis Patients with Rudimentary non Communicating Horn of Uterus with Functional Endometrium: A Retrospective Study

Low complete transverse vaginal septum, vesico-ureteric reflux and low anorectal malformation

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

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