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Transverse vaginal septae: management and long‐term outcomes
Author(s) -
Williams CE,
Nakhal RS,
HallCraggs MA,
Wood D,
Cutner A,
Pattison SH,
Creighton SM
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12899
Subject(s) - medicine , vagina , vaginoplasty , hysterectomy , population , abdominoperineal resection , obstetrics , retrospective cohort study , gynecology , surgery , cancer , environmental health , colorectal cancer
Objective To examine the management and long‐term outcomes of transverse vaginal septae. Design Observational study with cross‐sectional and retrospective arms. Setting Tertiary referral centre specialising in Müllerian anomalies. Population Forty‐six girls and women with a transverse vaginal septum. Methods Data from medical records of all cases (1998–2013) of transverse vaginal septae were collected and reviewed. Patients over 16 years of age also completed a questionnaire. Main outcome measures Presentation, examination findings, investigations, surgery, and long‐term reproductive outcomes. Results The septae in the study were described as follows: 61% (95% CI 0.46–0.74) were imperforate, and presented with obstructed menstruation; 39% (95% CI 0.26–0.54) were perforate, and presented with a variety of concerns; 72% (95% CI 0.57–0.83) were low, 22% (95% CI 0.12–0.36) were mid‐vaginal, and 6% (95% CI 0.02–0.18) were high; 33% were managed via an abdominoperineal approach, 59% were managed via a vaginal approach, and 6% had laparoscopic resection (one patient did not have surgery); 11% (95% CI 0.05–0.23) of patients presented with reobstruction, all following abdominoperineal vaginoplasty; 7% presented with vaginal stenosis, two following vaginal resection and one following the abdominoperineal approach; 61% of questionnaires were returned. These results showed that 22/23 patients were menstruating and one had a hysterectomy, 74% had been sexually active, 35% had dyspareunia, and 36% complained of dysmenorrhoea. There were seven pregnancies, with one termination and six live births, all following the vaginal excision of a transverse vaginal septum. Conclusions Transverse vaginal septae resected vaginally or laparoscopically have low complication rates and good long‐term outcomes. Complex septae require more extensive surgery, with an increased risk of complications.