Transverse vaginal septum presenting as secondary amenorrhoea: a rare clinical presentation

2020 ◽  
Vol 13 (8) ◽  
pp. e235374 ◽  
Author(s):  
Garima Yadav ◽  
Neha Agrawal ◽  
Sureka Binit ◽  
Pratibha Singh
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Menstrual Cycle ◽  
Clinical Presentation ◽  
Primary Amenorrhea ◽  
Early Age ◽  
Cell Debris ◽  
Vaginal Septum ◽  
Secondary Amenorrhea ◽  
Transverse Vaginal Septum

Transverse vaginal septum is one of the variants of Mullerian duct anomaly, caused as a result of defective fusion or recanalisation of vaginal and Mullerian organs. At an early age, it commonly presents as primary amenorrhea along with cyclical abdominal pain while later on usually it presents as dyspareunia and infertility. Our 22-year-old patient presented with secondary amenorrhea. It is very unusual for a transverse vaginal septum to cause secondary amenorrhea. MRI and clinical examination raised the suspicion of transverse vaginal septum causing secondary amenorrhea. She attained regular menstrual cycle after septum excision. The proposed theory behind it is obliteration of microperforated transverse vaginal septum because of menstrual blood and cell debris. Thus, a rare possibility of transverse vaginal septum should also be considered as a differential diagnosis of secondary amenorrhea.

Müllerian Anomalies: A Cause for Primary Amenorrhea

2017 ◽  
Vol 9 (3) ◽  
pp. 221-224
Author(s):  
Anuja V Bhalerao ◽  
Richa Garg
Keyword(s):  
Correct Diagnosis ◽  
Management Strategies ◽  
Androgen Insensitivity Syndrome ◽  
Primary Amenorrhea ◽  
Vaginal Septum ◽  
Imperforate Hymen ◽  
Secondary Sexual Characters ◽  
Transverse Vaginal Septum ◽  
Preservation Of Fertility ◽  
Secondary Sexual

ABSTRACT Introduction Primary amenorrhea is a challenging entity as it affects the reproductive outcome. Primary amenorrhea is an absence of secondary sexual characters until 14 years of age or absence of menstruation with secondary sexual characters until 16 years of age. Aim The aim of this article is to study the frequency, etiologic causes, presentation, diagnosis, and optimal mode of management of primary amenorrhea. Materials and methods All girls who had not attained menarche until 16 years of age in the absence of secondary sexual characters and until 14 years, if no secondary sexual characters, and were willing for follow-up were subjected to investigations and were treated as per the etiology. Results Mayer–Rokitansky–Küster–Hauser (MRKH) syndrome was the most common cause of primary amenorrhea (42.85%) followed by imperforate hymen (28.57%) and transverse vaginal septum (21.42%), one each of low, mid, and high varieties. There was one case of androgen insensitivity syndrome. Conclusion Establishing correct diagnosis is essential for planning treatment and management strategies in primary amenorrhea as treatment goals are preservation of fertility and progression of normal development. How to cite this article Bhalerao AV, Garg R. Müllerian Anomalies: A Cause for Primary Amenorrhea. J South Asian Feder Obst Gynae 2017;9(3):221-224.

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

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Firouzeh Ghaffari ◽  
Fatemeh Keikha ◽  
Arezoo Arabipoor
Keyword(s):  
Rare Case ◽  
Intrauterine Insemination ◽  
Uterine Cavity ◽  
Primary Amenorrhea ◽  
Hypothalamic Amenorrhea ◽  
Vaginal Septum ◽  
Transverse Vaginal Septum ◽  
Systematic Strategy ◽  
Atypical Presentations

We reported a rare case of hypothalamic amenorrhea and transverse vaginal septum. A 28-year-old woman presented with primary amenorrhea and no complaint of abdominal pain. Laparoscopy revealed a small rudimentary uterus with streak ovaries and a vaginal pouch. The patient with diagnosis of Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome was subjected to a vaginoplasty in another fertility center. In our institute, after two courses of estrogen and progesterone, sonography revealed hematocolpos, while, under anesthesia, transverse vaginal septum was resected. Hysteroscopy revealed normal uterine cavity. She became pregnant 5 months postoperatively with controlled ovarian stimulation (COS) in conjunction with intrauterine insemination, and she has two healthy babies now. This case highlights the importance of careful evaluation of all primary amenorrheas. Clinicians should be aware of presence of more than one etiology which causes atypical presentations and accomplishes a systematic strategy for the evaluation of amenorrhea potential to avoid long-term side effects of a misdiagnosis.

scholarly journals Complex mullarian duct abnormality in a young female: a theraputic dilemma

2017 ◽  
Vol 6 (8) ◽  
pp. 3673
Author(s):  
Mukta Agarwal ◽  
Bhawana Tiwary ◽  
Prajnanika Gurung
Keyword(s):  
Lower Abdominal Pain ◽  
Rare Condition ◽  
Young Female ◽  
Urogenital Sinus ◽  
Incomplete Fusion ◽  
Primary Amenorrhea ◽  
Vaginal Septum ◽  
Primary Amenorrhoea ◽  
Transverse Vaginal Septum ◽  
Mullerian Ducts

Genital outflow tract obstruction is a rare cause of primary amenorrhoea. Cervical agenesis is a very rare condition often associated with atresia of vagina. Clinical diagnosis is usually difficult before surgery. Transverse vaginal septum or vaginal agenesis is also a rare condition that results from incomplete fusion between vaginal components of the mullerian ducts and urogenital sinus. If the septum is complete, the menstrual flow will be obstructed causing primary amenorrhoea. The septum is basically a membrane of fibrous connective tissue with both muscular and vascular components formed anywhere along the vagina during embryological development. Here we present a case of 18 year old female who presented with primary amenorrhea, cyclical lower abdominal pain and menouria since 5 years. There was no history of attainment of menarche. The clinical examination revealed a small, blind ending lower vagina with a tough transverse membrane separating the lower portion from the upper genital tract. The ultrasound examination revealed a normal size uterus with hematometra. The magnetic resonance imaging of pelvis confirmed the presence of hematometra and transverse vaginal septum. Transverse vaginal septum resection followed by abdomino-perineal cervicoplasty was done in this patient.

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

2018 ◽  
Vol 12 (1) ◽  
pp. 66-68
Author(s):  
Rekha Paudel ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Abdominal Mass ◽  
Lower Abdominal Pain ◽  
Sex Characteristics ◽  
Vaginal Septum ◽  
Primary Amenorrhoea ◽  
Tanner Staging ◽  
Secondary Sex Characteristics ◽  
Transverse Vaginal Septum ◽  
Female Genital

Transverse vaginal septum is a congenital anomaly of the female genital outflow tract. It mostly remains unrecognized till adolescence and manifests as primary amenorrhoea with cyclic lower abdominal pain in background of appropriate Tanner staging secondary sex characterstics. Diagnosis is done by clinical examination and imaging, usually Magnetic Resonance Imaging. Early surgical management by vaginal or abdominal approaches improves the outcome. A 16 years, adolescent with appropriate Tanner staging secondary sex characteristics presented to gynecology (OPD) of Kathmandu Model Hospital with complaints of primary amenorrhoea and palpable abdominal mass of 24 weeks size with cyclic lower abdominal pain. Ultrasound showed features suggestive of hematometra. Under spinal anaesthesia, drainage and excision of the transverse vaginal septum was done followed by placement of vaginal mould post-operatively. We present here a case of primary amenorrhoea with pyometra secondary to transverse vaginal septum.

Secondary amenorrhea attributed to occlusion of microperforate transverse vaginal septum

2010 ◽  
Vol 94 (1) ◽  
pp. 351.e5-351.e10 ◽  
Author(s):  
Jennifer L. Nichols ◽  
Eric J. Bieber ◽  
Jennifer S. Gell
Keyword(s):  
Vaginal Septum ◽  
Secondary Amenorrhea ◽  
Transverse Vaginal Septum

scholarly journals Ultrasound Imaging of Cystic Nephroma

2017 ◽  
Vol 4 (3) ◽  
pp. 1-9 ◽  
Author(s):  
Federico Greco ◽  
Eliodoro Faiella ◽  
Domiziana Santucci ◽  
Delia De Lisi ◽  
Gianguido Lo Vullo ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Urinary Tract ◽  
Ultrasound Imaging ◽  
Clinical Presentation ◽  
Imaging Features ◽  
Cystic Nephroma ◽  
Cystic Lesions ◽  
Palpable Mass ◽  
Tract Infections

Cystic nephroma is a rare, benign multicystic lesion of the kidney. This tumor occurs both in children and in adults. In children, it is highly prevalent in males; in adults, it is more frequent in women. The term “cystic nephroma” represents two apparently different entities: pediatric cystic nephroma, a benign form thought to originate from metanephric tissue, and adult cystic nephroma, considered as a lesion of mixed epithelial stromal tumor. The clinical presentation may be a palpable mass or nonspecific symptoms such as abdominal pain, hematuria, and urinary tract infections. In this review, we summarize the ultrasound imaging features of cystic nephroma and describe the characteristics of the most common renal cystic lesions and the differential diagnosis of cystic nephroma with other renal cystic lesions.

scholarly journals Successful pregnancy outcome after septum resection and use of amnion graft in patient with high transverse vaginal septum

2019 ◽  
Vol 12 (6) ◽  
pp. e228769
Author(s):  
Rubina Sohail ◽  
Aisha Malik ◽  
Afroze Ashraf ◽  
Shahlla Kanwal
Keyword(s):  
External Genitalia ◽  
Vaginal Surgery ◽  
Thyroid Stimulating Hormone ◽  
Breast Development ◽  
Primary Amenorrhea ◽  
Stricture Formation ◽  
Vaginal Septum ◽  
Normal Limits ◽  
Transverse Vaginal Septum ◽  
Stimulating Hormone

A 20-year-old woman recently married presented to the outpatient department of the hospital, with primary amenorrhea and difficulty in having coitus. Her height was 155 cm, breast development was normal for age, and other secondary sexual characters seemed normal. On local examination, external genitalia was normal looking, and there was no vaginal discharge. She had a blind vagina of 2 cm length. The ultrasound showed a normal-sized uterus and ovaries seemingly normal. Hormonal profile comprising serum follicle-stimulating hormone, luteinising hormone, prolactin and thyroid stimulating hormone were all within normal limits. Karyotyping was done, which showed a 46,XX pattern. The patient underwent vaginal surgery during which septum resection was done, and amnion grafting was performed to prevent stricture formation. The patient resumed successful coitus 3 months after surgery. There was no discomfort on coitus. She conceived 7 months later. Following this, the patient delivered a healthy baby boy through caesarean section at term.

scholarly journals Uterine Didelphys with Transverse Vaginal Septum – A Complex rare Müllerian anomaly

2021 ◽  
Vol 28 (2) ◽  
pp. 2
Author(s):  
Dina Aisha Khan ◽  
Nalini Sharma ◽  
Anusmita Saha ◽  
Rituparna Das ◽  
Subrat Panda
Keyword(s):  
Genital Tract ◽  
Female Genital Tract ◽  
Primary Amenorrhea ◽  
Vaginal Septum ◽  
Primary Amenorrhoea ◽  
Transverse Vaginal Septum ◽  
Mullerian Anomaly ◽  
Lateral Fusion ◽  
Mri Evaluation

During the development of the female genital tract, any insult to the normal development process results in a set of intriguing abnormalities known as Müllerian duct abnormalities. The uterine didelphys is the second least common type of anomaly among these, which may commonly be associated with a longitudinal vaginal septum (lateral fusion defect). However uterine didelphys along with a transverse vaginal septum (lateral fusion plus resorption defect) is a very rare finding and to the best of our knowledge, thecase that we hereby report is the second one in literature.A 16-year-old unmarried girl presented with primary amenorrhoea and cyclical pain for 18months.On clinical examination and imaging, a case of uterine didelphys and transverse vaginal septum was found. Her urinary tract was normalon USG and MRI evaluation. Excision of the septum was done by abdomino-vaginal approach. The patient was discharged well.We conclude that a patient presenting with primary amenorrhea especially with cyclical dysmenorrhea with a transverse vaginal septum on examination should be thoroughly investigated for associated upper genital tract abnormalities as the treatment strategy and prognosis is largely dependent on the correct classification of the anomaly.

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