title: Transverse vaginal septae: management and long-term outcomes.
abstract: OBJECTIVE
  To examine the management and long-term outcomes of transverse vaginal septae.
  
  
  METHODS
  Observational study with cross-sectional and retrospective arms.
  
  
  METHODS
  Tertiary referral centre specialising in Müllerian anomalies.
  
  
  METHODS
  Forty-six girls and women with a transverse vaginal septum.
  
  
  METHODS
  Data from medical records of all cases (1998-2013) of transverse vaginal septae were collected and reviewed. Patients over 16 years of age also completed a questionnaire.
  
  
  METHODS
  Presentation, examination findings, investigations, surgery, and long-term reproductive outcomes.
  
  
  RESULTS
  The septae in the study were described as follows: 61% (95% CI 0.46-0.74) were imperforate, and presented with obstructed menstruation; 39% (95% CI 0.26-0.54) were perforate, and presented with a variety of concerns; 72% (95% CI 0.57-0.83) were low, 22% (95% CI 0.12-0.36) were mid-vaginal, and 6% (95% CI 0.02-0.18) were high; 33% were managed via an abdominoperineal approach, 59% were managed via a vaginal approach, and 6% had laparoscopic resection (one patient did not have surgery); 11% (95% CI 0.05-0.23) of patients presented with reobstruction, all following abdominoperineal vaginoplasty; 7% presented with vaginal stenosis, two following vaginal resection and one following the abdominoperineal approach; 61% of questionnaires were returned. These results showed that 22/23 patients were menstruating and one had a hysterectomy, 74% had been sexually active, 35% had dyspareunia, and 36% complained of dysmenorrhoea. There were seven pregnancies, with one termination and six live births, all following the vaginal excision of a transverse vaginal septum.
  
  
  CONCLUSIONS
  Transverse vaginal septae resected vaginally or laparoscopically have low complication rates and good long-term outcomes. Complex septae require more extensive surgery, with an increased risk of complications.
authors.affiliation: Department of Women's Health, University College London Hospital, London, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Williams
authors.forename: R S
authors.initials: RS
authors.lastname: Nakhal
authors.forename: M A
authors.initials: MA
authors.lastname: Hall-Craggs
authors.forename: D
authors.initials: D
authors.lastname: Wood
authors.forename: A
authors.initials: A
authors.lastname: Cutner
authors.forename: S H
authors.initials: SH
authors.lastname: Pattison
authors.forename: S M
authors.initials: SM
authors.lastname: Creighton
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D020884:Colpotomy; D003430:Cross-Sectional Studies; D004715:Endometriosis / Q000150:complications; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies; D061685:Time-to-Pregnancy; D014564:Urogenital Abnormalities / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery; D014623:Vaginal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult
keywords: Obstructed menstruation; primary amenorrhoea; transverse vaginal septum; vaginal agenesis