Moegni Fernandi, Quzwain Suhair, Rustamadji Primariadewi
Urogynecology Division Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Urogynecology Division Department of Obstetrics and Gynecology, Faculty of Medicine, University of Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Int J Surg Case Rep. 2021 Jun;83:105990. doi: 10.1016/j.ijscr.2021.105990. Epub 2021 May 20.
Transverse Vaginal Septum (TVS) is a rare congenital abnormality, classified as the Mullerian duct anomaly development. TVS incidence range from 1:2.000 to 1:72.000. Management of TVS may only requirement local excision with a simple end to end anastomosis of the vagina, and use of skin grafts, but this technique has been reported has common complications of secondary tissue contracture, which often lead to stenosis of the vagina. In this case we managed TVS with simple flap technique to avoid such postoperative complications and maintain caliber of vagina.
A 11 years old girl complained cyclical abdominal pain since a year ago without history of menstrual blood. Patient already had vaginal surgery for removing menstrual blood, but after vaginal surgery the menstrual blood cannot be removed, then referred to our hospital. Ultrasound examination revealed hematometra and hemocolpos. The septum location was 3,38 cm proximal distance from vaginal introitus with the thickness of 8.1 mm. We performed simple excision of the septum with formerly performed distal vaginal septum mucosa preparation creating lateral flaps, then approximating the flaps to the edge of the proximal vaginal mucosa with interrupted suture continued with hymenorraphy. The patient has no complaint 6 months after surgery with vaginal length 8 cm, and had regular menstrual cycle.
A simple flap surgery technique can be done in transverse vaginal septum, with no complication such as tissue contracture, vaginal stenosis, or insightly scarring. This is a simple technique and can be done with hymenorraphy to restore normal anatomy of hymen.
阴道横隔（TVS）是一种罕见的先天性异常，归类于苗勒管异常发育。TVS的发病率范围为1:2000至1:72000。TVS的治疗可能仅需要局部切除并进行简单的阴道端端吻合，以及使用皮肤移植，但据报道该技术有继发性组织挛缩的常见并发症，这常导致阴道狭窄。在本病例中，我们采用简单皮瓣技术治疗TVS，以避免此类术后并发症并维持阴道管径。
一名11岁女孩自一年前起出现周期性腹痛，无月经血史。患者此前已接受过阴道手术以排出经血，但术后经血仍无法排出，遂转诊至我院。超声检查显示子宫积血和阴道积血。隔膜位于距阴道口近端3.38 cm处，厚度为8.1 mm。我们对隔膜进行了简单切除，先前对远端阴道隔膜黏膜进行了准备以形成外侧皮瓣，然后用间断缝合将皮瓣与近端阴道黏膜边缘对合，接着进行处女膜修补术。术后6个月患者无不适，阴道长度为8 cm，月经周期规律。
对于阴道横隔可采用简单皮瓣手术技术，无组织挛缩、阴道狭窄或明显瘢痕等并发症。这是一种简单的技术，可与处女膜修补术一起进行以恢复处女膜的正常解剖结构。
