Transverse Vaginal Septum

Introduction

• Description: A transverse vaginal septum is a partial or complete obstruction of the vagina and is generally found at the junction of the upper third and lower two-thirds of the vaginal canal. The septum is generally less than 1 cm in thickness and may or may not have a small opening to the upper genital tract (the location and thickness are highly variable).

• Prevalence: 1/30,000–80,000 females.

• Predominant Age: Present at birth but generally not diagnosed until puberty.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Incomplete canalization of the Müllerian tubercle and sinovaginal bulb. Canalization is typically complete by 20 weeks gestation.

• Risk Factors: Partial septa have been reported in women exposed in utero to diethylstilbestrol.

Signs and Symptoms

• Blind, shortened vaginal pouch

• Primary amenorrhea

• Mucocolpos

• Hematocolpos

• Hematometra

• Foul vaginal discharge (with incomplete septum)

• Vaginal/abdominal mass without bulging of the vaginal outlet (hematocolpos and mucocolpos may be associated with urinary tract obstruction if very large)

Diagnostic Approach