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The purpose of this study was to improve the understanding of different types of oblique vaginal septum syndrome (OVSS), and to explore the efficacy of combined hysteroscopy-laparoscopic surgery and hysteroscopy in the treatment of OVSS, in order to provide a certain reference value for clinical diagnosis and treatment. The types, clinical manifestations, treatment methods and efficacies of 46 patients with OVSS who were treated in our hospital were retrospectively analysed. Forty-six patients underwent ultrasonography with a diagnostic accuracy of 100%. Among the 46 cases, 18 cases were type I, 20 were type II, five were type III and three were type IV. The postoperative VAS scores in both groups were significantly lower than those before surgery, indicating that postoperative abdominal pain symptoms were effectively relieved after surgery, and the remission rate was 100%. Of the 43 surgically treated patients, 26 had fertility requirements, of which 17 (65.4%) had a successful pregnancy. There are many types of OVSS, which should be diagnosed by ultrasound, magnetic resonance imaging (MRI) and hysteroscopy before surgery based on the clinical symptoms of patients. Besides, hysteroscopic trapezoidal septum resection is the most minimally invasive, simple and effective surgical method for the treatment of OVSS.Impact StatementWhat is already known on this subject?  Oblique vaginal septum syndrome (OVSS) is a congenital malformation of the female reproductive tract with a low incidence. The appearance of the external genitalia and normal menstruation before puberty made the diagnosis of OVSS difficult and the rate of misdiagnosis and missed diagnosis is high.What do the results of this study add?  Dysmenorrhoea or abdominal pain were the main reasons for the first diagnosis in patients with types I and IV OVSS, while vaginal discharge and abnormal menstruation were the main reasons for the first diagnosis in patients with types II and III OVSS. The combined hysteroscopic–laparoscopic surgery and hysteroscopic surgery can significantly alleviate OVSS.What are the implications of these findings for clinical practice and/or further research?  There are many types of OVSS, which should be diagnosed by ultrasound, magnetic resonance imaging (MRI) and hysteroscopy before surgery based on the clinical symptoms of patients. Besides, hysteroscopic trapezoidal septum resection is the most minimally invasive, simple and effective surgical method for the treatment of OVSS. What is already known on this subject?  Oblique vaginal septum syndrome (OVSS) is a congenital malformation of the female reproductive tract with a low incidence. The appearance of the external genitalia and normal menstruation before puberty made the diagnosis of OVSS difficult and the rate of misdiagnosis and missed diagnosis is high. What do the results of this study add?  Dysmenorrhoea or abdominal pain were the main reasons for the first diagnosis in patients with types I and IV OVSS, while vaginal discharge and abnormal menstruation were the main reasons for the first diagnosis in patients with types II and III OVSS. The combined hysteroscopic–laparoscopic surgery and hysteroscopic surgery can significantly alleviate OVSS. What are the implications of these findings for clinical practice and/or further research?  There are many types of OVSS, which should be diagnosed by ultrasound, magnetic resonance imaging (MRI) and hysteroscopy before surgery based on the clinical symptoms of patients. Besides, hysteroscopic trapezoidal septum resection is the most minimally invasive, simple and effective surgical method for the treatment of OVSS.

Diagnosis and treatment of 46 patients with oblique vaginal septum syndrome