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 .