title: Delayed diagnosis of partially obstructed longitudinal vaginal septa.
abstract: OBJECTIVE
  To report delayed diagnosis in two cases because of subtle manifestations of partially obstructive müllerian anomalies.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  The first case is a 30-year-old woman who was seen initially with irregular vaginal bleeding, dysmenorrhea, and dyspareunia. On physical examination she was noted to have an anterior vaginal mass with a fistulous tract adjacent to the cervix. Blood and mucus issued from the fistulous tract when the anterior blade of the speculum compressed the vaginal mass. In case 2 a 40-year-old nulligravida was seen with infertility and mild dysmenorrhea. Her history was significant for a Strassman's metroplasty. On examination she was noted to have a bulging at the apex of the vagina adjacent to the cervix.
  
  
  METHODS
  Transvaginal ultrasound, fistulogram, hysterosalpingogram, resection of the longitudinal vaginal septa, and cycle day 3 FSH.
  
  
  METHODS
  Symptoms.
  
  
  RESULTS
  In case 1 the subject had resolution of irregular vaginal bleeding, dysmenorrhea, and dyspareunia. In case 2 the patient declined to pursue further therapy.
  
  
  CONCLUSIONS
  Common gynecologic symptoms resulted from partially obstructed vaginal septa. These cases demonstrate the importance of a high index of suspicion in subjects who do not respond to standard therapies.
authors.affiliation: Sanford School of Medicine of the University of South Dakota, Sioux Falls, South Dakota 57105, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Ziebarth
authors.forename: Kathleen
authors.initials: K
authors.lastname: Eyster
authors.forename: Keith
authors.initials: K
authors.lastname: Hansen
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis; D000328:Adult; D004412:Dysmenorrhea / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007668:Kidney / Q000002:abnormalities; D009095:Mullerian Ducts / Q000002:abnormalities; D014463:Ultrasonography; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging