Delayed diagnosis of partially obstructed longitudinal vaginal septa.
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.
Ziebarth
Angela
A
Sanford School of Medicine of the University of South Dakota, Sioux Falls, South Dakota 57105, USA.
Eyster
Kathleen
K
Hansen
Keith
K
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