Vaginal Septum

What are the signs and symptoms of a vaginal septum?

• Longitudinal vaginal septum – Some girls with this type of septum will have a normal uterus, however the majority will also have a Müllerian anomaly such as a septate uterus or didelphic uterus. Patients with a longitudinal vaginal septum will have normal menstruation (periods), however may report difficulty using tampons or experience pain during intercourse. Sometimes women don't experience any symptoms, and their doctor discovers a vaginal septum during a routine pelvic examination.
• Transverse vaginal septum – In the case of a complete transverse vaginal septum, menstrual blood flow is blocked and causes the upper vagina and uterus to swell. Patients with this type of anomaly have absent menstruation (missed periods), worsening cyclic pelvic pain, and sometimes an abdominal mass, which is the uterus filled with blood. Patients might not experience any symptoms when a transverse vaginal septum is perforated. Alternatively, they may have difficulty using tampons and may experience painful intercourse.
• Obstructed hemi vagina – An obstructed hemi vagina is almost always associated with a didelphic uterus and a renal anomaly on the same side of the obstruction. Girls with this type of septum have normal menstruation, but experience worsening cyclic pelvic pain.

What tests are used to diagnose a vaginal septum?

At Children's Hospital Colorado, we diagnose a vaginal septum by performing both a pelvic examination and imaging tests using a 3-dimensional ultrasound or a magnetic resonant imaging (MRI) machine. Ultrasound imaging uses sound waves to create images of the inside of the abdomen and pelvis, while the MRI uses magnets to create images of internal structures and organs. Sometimes, a vaginal septum is associated with malformations of the skeletal system or the urinary tract, so additional X-rays and imaging of the kidneys may also be necessary.

The internal pelvic examination is a full physical exam of the pelvic structures. We recommend performing this exam while the patient is asleep under anesthesia to minimize any discomfort.

Why choose us for these imaging tests?

Vaginal septa are uncommon, and making a correct diagnosis is necessary before considering surgery. Given the rarity of these conditions, it is important that the radiologist is familiar with these malformations, which is why it is important to visit a hospital with an experienced radiology team.

Because Children's Colorado is a regional referral center for vaginal septa, our radiologists have the training and experience necessary to accurately diagnose these conditions.

How do we make a diagnosis for the uterine anomaly?

Once the imaging tests are complete, your physician will review this information along with the clinical history and pelvic examination to make a diagnosis.

How is a vaginal septum treated?

Surgical resection, or removal of the septal tissue, is the most definitive way to manage complications associated with a vaginal septum. However, the timing of surgery depends on the symptoms and characteristics of the septum. Women who don't show symptoms, usually those with non-obstructing septa, may not necessarily need intervention. But it is important to note that these septa can interfere with tampon use, intercourse, and childbirth, so surgery can be performed later to allow for comfortable tampon use, intercourse and safe vaginal delivery of a baby. See the types of vaginal septum resection we perform.

Why choose us for treatment of a vaginal septum?

Vaginal septa are uncommon conditions and they require management by an experienced multidisciplinary care team. Our team includes experts from radiology and psychology, as well as surgical specialists from gynecology, urology, pediatric surgery and colorectal surgery.

At Children's Colorado, we have the experience managing complex conditions and the team to optimize the surgical outcome and well-being of our patients. Because we are part of the Pediatric and Adolescent Gynecology Department, we understand that a lot of work we do is sensitive, especially when dealing with adolescent and teen girls experiencing physical and emotional changes in their lives. That's why we team up with pediatric psychologists to provide necessary emotional support for our patients: because the psychosocial well-being of our patients is just as important as their physical well-being.

The Center for Young Women's Health (CYWH) is an educational entity that is committed to providing teen girls and young women with carefully researched health information, educational programs and conferences.