Keywords:
Congenital, Imaging sequences, MR, Genital / Reproductive system female
Authors:
S. Nasir; Karachi/PK
DOI:
10.26044/ecr2019/C-3488
Aims and objectives
Transverse vaginal septum is a type of rare congenital uterovaginal anomaly (class II under the Rock and Adam classification).
The incidence of transverse vaginal septum is 1 in 70,000 female.
It may be an isolated anomaly or associated with other Mullerian duct anomalies.
It may occur at: upper vagina in 46%,
mid vagina in 40% and lower vagina in 14%.
It can be either perforate (incomplete) or imperforate (complete) due to failure of resorption of the tissues of embryological components of vagina between urogenital sinus and fused Mullerian ducts.
Majority may have a small hole called fenestration in the septum,
with menstrual flow taking longer time.
Complete vaginal septum presents with symptoms of vaginal obstruction which occur at the time of menarche.
Incomplete transverse vaginal septums are usually asymptomatic and diagnosed on pelvic exmination in patients presented with infertility or dysparenia but they present as obstructed labour.
An asymtomatic incomplete transverse septum does not require correction during childhood or adolescence since the menstrual blood flow from vagina.
Transverse vaginal septum requires surgical correction (i.e excision of fibrous septal tissue) when the patient has complains like infertility and dyspareunia.
The level of obstructed septum are easily be visualised on routine MRI pelvis due to proximal dilatation and accumulation of blood. However in cases of perforated septum, due to collapsed vaginal lumen it is difficult to evaluate the level of septum and its thickness.
Even in cases of obstructed septum we see the level but cannot assess the thickness of the septum.
The aim of this study was to evaluate the usefullness of vaginal opacification on MRI pelvis by endovaginal gel instillation,
for the detection of incomplete transverse vaginal septum,
a rare cause of female inferlity and dysparenia