title: Hysteroscopic resection of the vaginal septum in uterus didelphys with obstructed hemivagina: a case report.
abstract: Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare congenital anomaly. Excision of the obstructed vaginal septum is the treatment of choice for symptom relief and the preservation of reproductive capability. A 14-yr-old girl complained of persistent vaginal spotting following each menstruation. Pelvic magnetic resonance imaging revealed a uterus didelphys with left hematocolpos and ipsilateral renal agenesis. Instead of conventional transvaginal excision of the vaginal septum, we used hysteroscopic excision under transabdominal ultrasonographic guidance to preserve the integrity of the hymen. The postoperative course was uneventful, and clinical symptoms were completely resolved after this intervention. Resectoscopic excision of the vaginal septum was found to be easy, safe, effective, and appropriate for young women as it preserved hymen integrity. We believe that this is the first Korean report on the use of a hysteroscopy for vaginal septum resection in a patient with uterus didelphys with obstructed hemivagina.
authors.affiliation: Department of Obstetrics & Gynecology, The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Tae Eun
authors.initials: TE
authors.lastname: Kim
authors.forename: Gyoung Hoon
authors.initials: GH
authors.lastname: Lee
authors.forename: Young Min
authors.initials: YM
authors.lastname: Choi
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: Jee
authors.forename: Seung Yup
authors.initials: SY
authors.lastname: Ku
authors.forename: Chang Suk
authors.initials: CS
authors.lastname: Suh
authors.forename: Seok Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Jung Gu
authors.initials: JG
authors.lastname: Kim
authors.forename: Shin Yong
authors.initials: SY
authors.lastname: Moon
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007668:Kidney / Q000002:abnormalities; D014463:Ultrasonography; D014564:Urogenital Abnormalities / Q000601:surgery; D014599:Uterus / Q000002:abnormalities*; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*