Primary amenorrhea with transverse vaginal septum and scant hematocolpos: A case report

Abstract

Background: A genital outflow tract obstruction is an uncommon cause of primary amenorrhea. If ovulation occurs, menstrual bleeding is prevented. Patients typically present with abdominal/pelvic pain due to hematocolpos. Absence of significant hematocolpos could indicate a secondary source of primary amenorrhea and be challenging to the clinical diagnosis. Case: 17 year-old patient with primary amenorrhea, appropriate Tanner staging secondary sex characteristics, and transverse vaginal septum presents with virtual absence of hematocolpos. After vaginal septum resection, the patient began menstruating, although only evidenced by two cycles of vaginal spotting. Conclusion: Significant hematocolpos is an expected sequella of distal outlet obstruction when collated with secondary sexual characteristics. Absence of such along with suboptimal return of menstruation reflects pathophysiology which may be attributed to a coexistent disorder of the hypothalamus or higher central nervous system function

Surgical management of a transverse vaginal septum: About a rare case

“…In case of voluminous hematocolpos, it will be undertaken secondarily after debridement of the latter, making it possible to control the quality of the emptying. Laparoscopy is not essential if an MRI has been performed previously [ 9 ].…”

A Rare Case of Primary Amenorrhea with Two Etiologies, Hypothalamic Amenorrhea, Transverse Vaginal Septum, and No Hematocolpos

“…Typically, distal occlusions of female genital tract are associated with hematocolpos or hematometra which are manifested with cyclic pelvic pain and amenorrhea [ 4 ]. This is considered as a rare case due to presence of a distal obstruction, without abdominal pain and hematocolpos.…”

“…This is considered as a rare case due to presence of a distal obstruction, without abdominal pain and hematocolpos. As reported by Homa et al, the location of septum can influence the timing and type of presentation [ 4 ]. The location of septum in present case was in the upper two-thirds of the vagina, which occurs in less than 15 percent of patients [ 4 ].…”

“…As reported by Homa et al, the location of septum can influence the timing and type of presentation [ 4 ]. The location of septum in present case was in the upper two-thirds of the vagina, which occurs in less than 15 percent of patients [ 4 ]. Our patient was misdiagnosed with MRKH syndrome in another fertility center because uterine growth had been stopped due to estrogen deficiency caused by hypogonadotropic hypogonadism (HH), leading to lack of cyclic pelvic pain due to amenorrhea and symmetrical age-appropriate secondary sexual development that was coincident with blind vagina.…”

Primary Amenorrhoea with Transverse Vaginal Septum Presented with Infected Pyometra of 24 Weeks Size

“…A transverse vaginal septum/imperforate hymen represent only 3-5% of cases. 4 Thus, a genital outflow tract obstruction is an uncommon cause of primary amenorrhoea. 2 A transverse vaginal septum may result from a failure of complete canalization of the primordial vaginal plate or from lack of union, which represents the junction of the urogenital sinus and the paramesonephric duct contribution.…”