Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. n ftemi asso amtclo stetases aia etm hstases aia septum meet to vaginal ducts transverse parameonephral this the of septum, failure vaginal or transverse plate vaginal the the is of channelling haematocolpos incomplete of from causes either results main to for the department of her our One in in . followed placed was was or patient cream stenosis : The vaginal oestrogen Discussion of operation. in circumference recurrence the soaked entire any after the septum sponge without day of years the A tarring the 2 of simple removed 4). a excision and by (Figure circumferential stenosis sutured A suture prevent vagina, then the were absorbable . of edges 2-0 septum the vaginal transverse using remaining visualising the the and of and centre 3) made the was (Figure in located incision hematocolpos sized transverse septum the normal a vaginal a draining a transverse making of low of found form consisted a ultrasound treatment the of perineal The presence in and the septum Pelvic with 2). transverse 10*12cm (Figure 1). a of thick (Figure by haematocolpos 1cm hymen large obstructed a the totally with hypogastric from vagina the cm a in never 1 sensitivity found has diaphragm a examination she with vaginal vagina characteristics that The sexual reports secondary patient consultation normal area. The for found presents examination context. she clinical agenesis, The primary kidney life. right a her congenital in of in pain history sex pelvic a had chronic with cyclic management patient a old its year with as 16 possible, a as is early This stenosis as vaginal out of : carried rate cases case be high complex should Clinical a more and with in surgical on associated and is especially ultrasound is treatment and transperineal cavity examination even vaginal The after gynaecological or the clinical scan. transrectal in careful MRI or a menarche abdomen an on menstrual after the based of via shortly is accumulation scan pain septum an ultrasound part vaginal pelvic as a central completely cyclic defined of the can with diagnosis is to in obstacles associated The Haematocolpos structural 22% according haematocolpos girls. vagina, These vagina cause adolescent the discharge. the can in of vaginal and vagina of for part vagina the part allows lower the lower of which the obstruct perforation the part in eccentric are in upper an septums are the have with the locations in tract of common 6% 72% genital most and so female its publications, the and latest conductors of vagina, the Mullerian the abnormality and in rare sinus anywhere a 1/7200 urogenital the and is of 1/2100 septum channelling between vaginal of or incidence septum an vaginal transverse The : Introduction 2020 16, November 1 report Moussaoui case el Kamal a girl: adolescent with an complicated in septum hematocolpos vaginal transverse a of Management nvri´ oamdVd Rabat de V Universit´e Mohammed 1 MN LAKHDAR AMINA , 3 hs et r sal omr hn1c hc n usually and thick cm 1 than more no usually are septa These . 1 h otcmo tooyi eeti h uinand/or fusion the in defect a is etiology common most The . 1 n zi baidada azziz and , 1 2 5 h rnvrevgnlspu a develop can septum vaginal transverse The . . 1 4 . Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. r xrml aibeacrigt t hp n oain amtclo ean h anconsequence main the remains Haematocolpos location. discovery and its for shape reasons its the tract, to genital female according the variable of anomaly extremely to rare are a necessary remains to septum follow-up is vaginal need transverse regular parents The age of their early importance and the an patients and at these : complications Therefore, Conclusion long-term haematocolpos . potential the these of of about risk informed drainage the be reduce with and septum fertility vaginal preserve , the as such of surgery, after Management described problems. are fertility complications site and common surgical less irregularities the Other menstrual at procedure. stenosis the and of scarring success complication reduce common methods. most to surgical the help other remains may to site compared resection technique the to at best and stenosis al. the Vaginal management al. as et surgical experience et years Sardesai facilitate 20 vagina. to Layman vaginal after catheter management the simple by wall a balloon of vaginal a performed Olbert with with narrowing an patients was patients postoperative using for technique vagina limit in reserved the this used is of technique is distension of traction proximal and modification part The approach, surgery. A other after abdominal-vaginal the obstruction. restenosis combined in of a incision risk requires cross higher a former and The septum techniques. al. the et of Bijsterveldt part Van Gr caudal the the is in closure approach incision transverse surgical al. with cross-shaped Another et a wall. excision Williams vaginal vaginal of simple the vaginoplasty, drainage. consists of abdomino-perineal before laparotomy resection haematocolpos routes: laparoscopic experience different a and the 3 has In by patient treated condition. VSDs the this with if of management easier surgical is the surgery al. on trans- literature et ultrasound, the Dennie in abdominal of available by management is assessed young attempting anaesthesia. data often Most before little general most Very MRI without is clinically or examination. examination septum assess ultrasound an rectoabdominal the trans-rectal such to and/or of or undergo difficult the vaginal location perineal not in is and careful do bulge thickness septum activities a visible the vaginal sexual undergo a Therefore, transverse first cause to a their not willing before of does is women location pressure On patient exact suprapubic hymen. a hymen. present, and imperforated imperforated unless is thickness an the septum of The of examination. transverse case distension physical a the perineum. visible in if on causes lips hand, septum suprapubically the other between vaginal applied amenorrhea. lower the observed pressure transverse primary often slight with is a e.g. addition, bulge associated from nature, In a symptoms distinguished with in these appearance easily gynecological with bluish is women The not young hymen often all hymen, imperforate are in imperforate An sought symptoms an routinely the to be chronic as Similar should pain, challenge, abnormality. back low mullerian diagnostic pain, difficult, common a abdominal more a present is not diagnosis can symptoms is the it pain septum incomplete, or abdominal vaginal haematos- is dyspareunic present transverse septum or only the patient The haematometry with clinically, If asymptomatic haematocolpos, case, septum. be perfo- a the our may a of of in it is location presence as as there the the complete, not on with is or depending whether septum amenorrhoea alpinx on the primary In all, If with above stimulation. associated pre-pubertal septum. hormonal depending, produced maternal variable, the In secretions to is of genital presentation respond post-puberty. ration of which clinical drainage or glands the the puberty, reproductive pre-puberty in proximal post obstruction either the an made of by hypersecretion caused is by anomaly. septum a this present vaginal of they transverse patients, frequency low of the diagnosis to The due rare remain they However, published. sinus urogenital the 11 h etmsol ermvdwe h ilrahsteaeo rtmntuto,and , first of age the reaches girl the when removed be should septum the , 6 aia etmwsfis ecie n17 n ic hnohrcs eishv been have series case other then since and 1877 in described first was septum Vaginal . 15 13,14 rpsdtonwtcnqe o h ramn ftevgnlwl:ps n pull and push wall: vaginal the of treatment the for techniques new two proposed . 8 ruiayretention urinary or , 2 19 17 hspsoeaiedlto sesnilt the to essential is dilation postoperative this , ecie obecospat/-lsyfor cross-plasty/Z-plasty double a described 9 7 nosrciegntlanomaly genital obstructive An . 10 . 18 . otprtv aia dilation vaginal postoperative , 16 negrmto,which method, unberger ¨ 12 ihtato through traction with ecie4 patients 46 describe 19,20 . Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. .DlgooluE aaz ,Sfui ,Klmoa ,Ceta .Mngmn fhmtclo nado- in 10.1007/s00404- hematocolpos Doi: of 2012;285(04):1083–1087. Management Obstet G. Gynecol Arch Creatsas 011-2114-4 and septum. T, vaginal management Kalampokas transverse C, septae: with Sofoudis vaginal lescents C, Transverse Iavazzo al. E, Deligeoroglou et 4. D, Wood MA, 2014;121(13):1653-8. BJOG Hall-Craggs outcomes. RS, long-term Nakhal CE, Williams 3. M MR. Laufer LL, Breech 2. Pediatr J umbilicus. the 2009;22(1):e1–3. at Gynecol mass abdominal an with amenorrhea Primary AC. Adolesc Steinberg B, Vakili EK, Saks 1. interests. competing no R´ef´erences have they : that declare Editor-in-Chief authors the The by review for available interests is Competing consent written report ofthe case journal. this copy of this A publication of images. for parent/guardian accompanying patient’s any the from and obtained applicable. was not consent participate informed Written to Consent study. current publication the for with proceed Consent to obtained been has approval Ethics participate on to author consent corresponding and the approval from available Ethics are study current the request. during analyzed reasonable and/or used datasets The materials and data declared. of be Availability to sources funding no the are drafting There manuscript in the involved of been version final has Funding the substantial they approved made and data; AL read of authors and All acquisition AB drafting content. and in intellectual design beeninvolved intellectual important has important and for manuscript. she for conception critically and critically to it data it revising of revising contributions and interpretation and manuscript to manuscript the contributions interpretation the drafting substantial and in made analysis involved data, AL been of content. has acquisition design, he and data; conception of to contributions substantial incision made the KE of edges the suturing vagina after the Authors’contributions obtained of result spetum final transverse the the 4: of mass Figure incision anechogenic after large drainage a haematocolpos of 3: form Figure the in haematocolpos the bladder. showing the image compressing ultrasound Suprapubic of 2: vagina Figure risks the the obstructing septum account Transverse into 1: Figure taking tract. while genital surgery upper : the on Figures on based repercussions essentially the and managementis stenosis the postoperative septums, these of leinaoais bttGnclCi ot m2009;36(1):47–68. Am North Clin Gynecol Obstet anomalies. ullerian ¨ 3 Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 0.Rc A au A lg M oe rH,TLneR.Pennyscesfloigsria cor- surgical following 1982;59(4):448e51. success Gynaecol Pregnancy Obstet RW. TeLinde septum. vaginal HW, transverse Jr complete Jones and AM, hymen Dlugi imperforate HA, 2015. of Zacur Gynaecol rection JA, Obstet Rock Rep . Case Management 20 excision. A. Pickens septum Gantt vaginal T, transverse Robert //dx.doi.org/10.1155/2015/975463. after DePond http: L, formation cloacal David stricture Williams differentiation, recurrent D, of sexual Joseph Bozzay urology. of Campbell-Walsh Ridhima, editor. Gupta disorders AJ, 19. Wein of In: 2007. girls. management Saunders; in Philadelphia: Surgical genitalia ed. the Martin. 9th of abnormalities Kaefer other and C, malformation an Richard hydronephrosis: .Rink bilateral 18 with 1995;13(03):337–339 hymen Med Imperforate Emerg A. J diagnosis. Sama J, Loscalzo department M, emergency Catapano unusual IL, Loscalzo 17. Steril Fertil anastomosis. low 10.1016/j.fertnstert.2009.12.061 facilitate Doi: and catheter 2010;94(06):2316–2318. balloon mucosa Olbert vaginal the proximal using septum the vaginal mobilize transverse of to Management Adolesc PG. McDonough Pediatr LC, J Layman technique. 16. a push-through or the septum versus 10.1016/j.jpag.2008.02.008 vaginal pull-through transversal Doi: vaginal congenital 2009;22(03):157–161. The a Gynecol vagina. with the patients of of Treatment aplasia Gynecol W. partial Willemsen 2003;101(5 Obstet C, Gynecol Bijsterveldt Obstet J van septa. vaginal 15 Am transverse with women septum. in vaginal labor 2):1110–1112 of Trial transferse Pt DJ. Rouse congenital EN, Blanton of 14. correction for Z-plasty Doi:10.1016/0002-9378(67)90357-2 1967;99(08):1164–1165. long-term RF. and management Garcia septae: vaginal treatment 13. Transverse 10.1111/1471-0528.12899 al. new Doi: et (13):1653–1658. a MA, 2014;121 Hall-Craggs Doi: hematocolpos: BJOG RS, 1853–1857. outcomes. Nakhal of 2010;94(05): CE, Steril Williams drainage Fertil . Laparoscopic septum. 12 vaginal S. transverse Grover a of D, management Watson 10.1016/j.fertnstert.2009.09.041 acute S, the for Pillay option J, 2008;51: Dennie Gynecol 11. Obstet cases Clin two anomalies. vaginal pain: of abdominal correction of 223–36 Surgical cause L. 2007;20:245–7. rare Breech Gynecol hymen—a R, Adolesc Imperforate Miller Pediatr 10. A. J Cetin literature. M, the and Erginbas of constipation review B, chronic and Dane with presenting C, 2004;45:340–2. Taiwan hymen Dane Paediatr Imperforate 9. Acta DL. case. Hwang one W, of Yang report MH, lumbago: 1996;44(5):493-5. Chen Pediatr W, Esp. Wang var´on. An un 8. incluido casos, nuevos S´ındrome McKusick- Guti´errez al. de cinco F, Cant´o et Aportaci´on Celis de M, de Kaufman: 8 Pizarro Oca˜na JM, 1982;59(04):448–451 correc- RM, Losa Gynecol Esteban surgical Paredes Obstet following 7. septum. success vaginal Pregnancy RW. transverse TeLinde complete JonesHWJr, and AM, Deligeoroglou hymen Dlugi imperforate HA, of Zacur tion JA, Rock . 6 1997:687-729. Lippincott-Raven; Philadelphia: M ed. the 8th of gynecology. anomalies for Surgery JA. Rock 5. leindcs nRc A hmsnJ,es eid’ operative Telinde’s eds. JD, Thompson JA, Rock En ducts. ullerian ¨ 4 Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 5 Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 6 Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 7 Posted on Authorea 16 Nov 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.160554791.15705556/v1 — This a preprint and has not been peer reviewed. Data may be preliminary. 8