Clinical case :
This is a 16 year old patient with a history of congenital right kidney
agenesis, she presents for consultation with a cyclic chronic pelvic
pain in a primary amenorrhea context. The patient reports that she has
never had sex in her life.
The clinical examination found normal secondary sexual characteristics
with a sensitivity in the hypogastric area. The vagina examination found
a vagina totally obstructed by a transverse septum in the form of a
vaginal diaphragm 1 cm from the hymen (Figure 1). Pelvic and perineal
ultrasound found a normal sized uterus with a large haematocolpos of
10*12cm with the presence of a low transverse vaginal septum located 1cm
thick (Figure 2).
The treatment consisted of making a transverse incision in the centre of
the transverse septum of the vagina, draining the hematocolpos (Figure
3) and visualising the cervix. A circumferential excision of the septum
was made and the remaining vaginal edges were then sutured by a simple
tarring of the entire circumference using 2-0 absorbable suture (Figure
4). A sponge soaked in oestrogen cream was placed in her vagina to
prevent stenosis and removed the day after the operation. The patient
was followed in our department for 2 years without any recurrence of
vaginal stenosis or hematocolpos .