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Transverse vaginal septum: a case report

  • Hilwah Nora ,
  • Ima Indirayani ,
  • Rusnaidi ,
  • Heyza Damara Mutyara ,


Introduction: Transverse vaginal septum or known as partial vaginal agenesis, is a rare case. The most frequent causes are defects or fusion disorders of the Mullerian Ductus and defect formation of the urogenital ducts of the urogenital sinuses. The septum may obstruct the entire vaginal opening and cause hematocolpos. The diagnosis is based on a detailed physical and gynecological examination supported by ultrasound and magnetic resonance imaging (MRI). The management option is surgery which is performed as soon as possible.

Case Report: An 11-year-old girl came with lower abdominal pain and amenorrhea, diagnosed with a transverse vaginal septum complicated with hematocolpos based on anamnesis, physical and gynecological examination, and imaging study by ultrasound and MRI. The management includes excision and cross-incision of the septum followed by diagnostic laparoscopy. Endometriosis was found at the broad ligament during laparoscopy and continued with endometriosis resection.

Conclusion: The transverse vaginal septum is still one of the rare anomalies of the Mullerian Duct. The diagnosis was made from a history of low abdominal pain, primary amenorrhea, and a pelvic examination that revealed the vaginal septum. MRI is a gold standard examination procedure of anomalies or abnormalities involving the vagina. The management of the transverse vaginal septum is a surgical approach involving drainage of hematocolpos.


  1. Utama BI, Ermawati E. Transverse vaginal septum. J Obgin Emas [Internet]. 2019;1(2):68–72. Available from:
  2. Quint EH, McCarthy JD, Smith YR. Vaginal surgery for congenital anomalies. Clin Obstet Gynecol. 2010;53(1):115-24. doi: 10.1097/GRF.0b013e3181cd4128.
  3. Williams CE, Nakhal RS, Hall-Craggs MA, Wood D, Cutner A, Pattison SH, et al. Transverse vaginal septae: management and long-term outcomes. BJOG An Int J Obstet & Gynaecol [Internet]. 2014;121(13):1653–8. Available from:
  4. Cunningham FG, Gant NF, Leveno KJ, Larry C. Williams Obstetrics, 21st Edition. J Midwifery & Women’s Heal [Internet]. 2003;48(5):369. Available from:
  5. Jain N, Gupta A, Kumar R, Minj A. Complete imperforate tranverse vaginal septum with septate uterus: A rare anomaly. J Hum Reprod Sci [Internet]. 2013 Jan;6(1):74–6. Available from:
  6. Moegni F, Quzwain S, Rustamadji P. Transverse vaginal septum managed by simple flap surgery technique: A case report. Int J Surg Case Rep [Internet]. 2021/05/20. 2021 Jun;83:105990. Available from:
  7. Scutiero G, Greco P, Iannone P, Bernardi G, Greco F, Nappi L. Management of Transverse Vaginal Septum by Vaginoscopic Resection: Hymen Conservative Technique. Rev Bras Ginecol Obstet. 2018;40(10):642-646. English. doi: 10.1055/s-0038-1670714.
  8. Brander EPA, Vincent S, McQuillan SK. Transverse Vaginal Septum Resection: Technique, Timing, and the Utility of Dilation. A Scoping Review of the Literature. J Pediatr Adolesc Gynecol [Internet]. 2022;35(1):65–72. Available from:
  9. Kamal EM, Lakhdar A, Baidada A. Management of a transverse vaginal septum complicated with hematocolpos in an adolescent girl: Case report. Int J Surg Case Rep [Internet]. 2020/11/20. 2020;77:748–52. Available from:
  10. Dennie J, Pillay S, Watson D, Grover S. Laparoscopic drainage of hematocolpos: a new treatment option for the acute management of a transverse vaginal septum. Fertil Steril [Internet]. 2010;94(5):1853–7. Available from:
  11. Deligeoroglou E, Iavazzo C, Sofoudis C, Kalampokas T, Creatsas G. Management of hematocolpos in adolescents with transverse vaginal septum. Arch Gynecol Obstet [Internet]. 2011;285(4):1083–7. Available from:
  12. Miller RJ, Breech LL. Surgical Correction of Vaginal Anomalies. Clin Obstet & Gynecol [Internet]. 2008;51(2):223–36. Available from:
  13. Dani MA, Azinar AD, Kurniawati EM, Paraton H, Hardianto G, Hadi THS. The outcome of Manchester operation in cervical elongation patients with pelvic organ prolapse at Dr. Soetomo Hospital, Surabaya from January 2015 to June 2017. Maj Obstet & Ginekol [Internet]. 2020;28(1):24. Available from:
  14. lanton EN, Rouse DJ. Trial of Labor in Women With Transverse Vaginal Septa. Obstet & Gynecol [Internet]. 2003;101(Supplement):1110–2. Available from:
  15. Garcia RF. Z-plasty for correction of congenital transverse vaginal septum. Am J Obstet Gynecol [Internet]. 1967;99(8):1164–5. Available from:
  16. Wierrani F, Bodner K, Spängler B, Grünberger W. "Z"-plasty of the transverse vaginal septum using Garcia's procedure and the Grünberger modification. Fertil Steril. 2003 Mar;79(3):608-12. doi: 10.1016/s0015-0282(02)04803-3. PMID: 12620448.
  17. van Bijsterveldt C, Willemsen W. Treatment of Patients with a Congenital Transversal Vaginal Septum or a Partial Aplasia of the Vagina. The Vaginal Pull-through Versus the Push-through Technique. J Pediatr Adolesc Gynecol [Internet]. 2009;22(3):157–61. Available from:
  18. Layman LC, McDonough PG. Management of transverse vaginal septum using the Olbert balloon catheter to mobilize the proximal vaginal mucosa and facilitate low anastomosis. Fertil Steril. 2010;94(6):2316-8. doi: 10.1016/j.fertnstert.2009.12.061. Epub 2010 Feb 20. PMID: 20172517.
  19. Sardesai SP, Dabade R, Chitale V. Double Cross Plasty for Management of Transverse Vaginal Septum: A 20-Year Retrospective Review of Our Experience. J Obstet Gynaecol India. 2015 May;65(3):181-5. doi: 10.1007/s13224-014-0542-3. Epub 2014 Jun 27. PMID: 26085740; PMCID: PMC4464565.
  20. Rink RC, Kaefer M. Surgical Management of Disorders of Sexual Differentiation, Cloacal Malformation, and Other Abnormalities of the Genitalia in Girls [Internet]. Campbell-Walsh Urology. Elsevier; 2012. p. 3629-3666.e6. Available from:
  21. Mathew AG. A Case Exemplifying Sampson’s Theory of the Aetiology of Endometriosis. Aust New Zeal J Obstet Gynaecol [Internet]. 1963;3(4):159–61. Available from:
  22. Brosens IA, Brosens JJ. Endometriosis. Eur J Obstet & Gynecol Reprod Biol [Internet]. 2000;90(2):159–64. Available from:
  23. Pitot MA, Bookwalter CA, Dudiak KM. Müllerian duct anomalies coincident with endometriosis: a review. Abdom Radiol [Internet]. 2020;45(6):1723–40. Available from:
  24. Singh S, Biswas M, Dey M, Nambula V, Abbas F. A rare case of low transverse vaginal septum. Int J Reprod Contraception, Obstet Gynecol [Internet]. 2015;3003–6. Available from:
  25. Alaniz, V.I., Quint, E.H. (2016). Transverse Vaginal Septum. In: Pfeifer, S. (eds) Congenital Müllerian Anomalies. Springer, Cham.
  26. Alaniz VI, Quint EH. Transverse Vaginal Septum [Internet]. Congenital Müllerian Anomalies. Springer International Publishing; 2016. p. 43–54. Available from:

How to Cite

Nora, H., Indirayani, I. ., Rusnaidi, & Mutyara, H. D. . (2023). Transverse vaginal septum: a case report. Bali Medical Journal, 12(2), 2172–2175.




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