Title: Transverse vaginal septum across adolescence and adulthood: a three-case series from a Moroccan tertiary center
Authors: Kenza Benchaaboune
Yassine Belhaj
Zineb Tazi
Sofia Jayi
Fatima Zahrae Alaoui Fdili
Hekmat Chaara
My Abdelilah Melhouf. Department of Gynecology
Obstetrics II
Hassan II University Hospital
Fez
Morocco.
Volume: 10
Issue: 6
Pages: 94-99
Publication Date: 2026/06/28
Abstract:
Transverse vaginal septum is a rare obstructive Mullerian anomaly with a wide clinical spectrum, ranging from acute pubertal hematocolpos to adult dyspareunia, infertility, or recurrent vaginal stenosis after previous surgery. We report a three-case series managed in a tertiary gynecology department in Morocco. The first patient was a 13-year-old adolescent with primary amenorrhea and acute pelvic pain due to hematocolpos associated with an upper-third transverse vaginal septum; emergency ultrasound-guided drainage was followed by definitive vaginal septum resection, postoperative antibiotics, local care, and progressive dilation, with restoration of painless regular menstruation at six months. The second patient was a 22-year-old nulligravid woman with severe dyspareunia and difficult intercourse despite menstrual flow; magnetic resonance imaging confirmed a lower-third perforated septum with a narrow opening, and surgical enlargement with postoperative dilation led to marked functional improvement. The third patient was a 30-year-old nulligravid woman previously operated on for vaginal septum who presented with disabling dysmenorrhea and spaniomenorrhea caused by recurrent lower vaginal stenosis; reoperation allowed drainage of retained old blood and progressive Hegar dilation. This series highlights the need for careful clinical examination, pelvic imaging, individualized surgery, and structured postoperative dilation to prevent restenosis and preserve menstrual, sexual, and reproductive function.