Vaginal Septum Resection

What is a vaginal septum resection

Vaginal septum resection is the main surgical procedure used to treat a vaginal septum. Resection is the act of surgically removing something from the body. In this case, it refers to the removal of a septum, which is a partition made of tissue that forms as the fetus is forming inside the womb.

The septum can interfere with menstruation, sexual function and childbirth, which is why its removal is often necessary. The timing of surgery depends on the symptoms and characteristics of the septum. The surgeon will typically need to perform a pelvic examination, pelvic imaging with ultrasound and magnetic resonant imaging (MRI) before surgery.

Vaginal septum is an uncommon condition that is congenital, meaning that it exists at birth.

Types of vaginal septa and their treatment

There are three different types of vaginal septa, and they require different forms of treatment.

Longitudinal vaginal septum

A longitudinal vaginal septum divides the vagina into two canals. To correct this, surgeons need to perform a vaginal septum resection, surgically removing the septal tissue to create a single vaginal canal.

Transverse vaginal septum

It is critical that the surgeon thoroughly understands the characteristics of a transverse vaginal septum prior to considering vaginal septum resection. Those with a menstrual obstruction due to a complete transverse vaginal septum will require surgery. Having a menstrual obstruction means that the septum is blocking the flow of menses that accompanies a monthly period. It is important to consider you or your child’s age and maturity before deciding on the procedure.

Prior to scheduling surgery to remove the septum, the surgeon may suggest draining the obstructed menses or suppressing hormones using medication to minimize menses during periods. The goal of these initial treatments is to delay performing a vaginal septum resection for young patients who are not yet ready for surgery and post-operative care.

Obstructed hemi vagina

In the case of an obstructed hemi vagina, the surgeon will perform a vaginal septum resection in order to create a single vaginal canal and relieve menstrual obstruction.

Why choose us for vaginal septum resection

Vaginal septa are uncommon conditions that require management by an experienced multidisciplinary care team. At Children’s Hospital Colorado, our team includes experts from radiology, pediatric anesthesiology and psychology, as well as surgical specialists from gynecology, urology, pediatric surgery and colorectal surgery.

Our radiology and anesthesiology experts help us prepare you or your child for the procedure. Our radiologists consult with our surgical specialists to decide the best approach for the surgery, using detailed images to help surgeons visualize the unique characteristics of each procedure. Our anesthesiologists are specially trained to work with children and teenagers, ensuring they administer precise dosages based on age and body type.

Our surgical specialists collaborate to consider every possible implication of the surgery during and after the procedure. After the surgery, our psychologist provides emotional support for you or your child to ensure strong physical and mental health.

At Children’s Colorado, we have the experience to manage complex conditions like vaginal septa and the multidisciplinary team to provide high-quality, comprehensive treatment, which includes addressing the psychosocial well-being of children, teens and young adults.

What to expect during vaginal septum resection

You or your child’s surgeon will perform the vaginal septum resection in an operating room while under general anesthesia. Depending on the complexity of the case, the procedure can take anywhere from 1 to 3 hours.

What to expect after vaginal septum resection

Vaginal septum resection is generally an outpatient procedure, which means patients can go home after they have recovered from anesthesia. After the procedure, you or your child may feel genital soreness, which you can manage with over-the-counter ibuprofen or acetaminophen. You or your child may also experience light vaginal bleeding. Nothing should be inserted into the vagina until cleared by a physician. Most patients can return to school or work within 2 to 5 days.

If there is a risk for vaginal scarring, the surgeon may leave in a vaginal stent or advise post-operative vaginal dilation. Vaginal dilation is a method of therapy used to stretch the tissues of the vagina to restore vaginal capacity and elasticity, which helps to alleviate sexual discomfort.

Risk of scarring based on vaginal septum type

After vaginal septum resection, you or your child may experience scarring, which varies depending on the type of surgery:

• Longitudinal vaginal septum: There is minimal risk of vaginal scarring with this type of septum resection, therefore post-operative vaginal dilation is not required.
• Transverse vaginal septum: Given the high risk for vaginal scarring with this type of septum resection, we usually recommend post-operative dilation to maintain vaginal patency, or the ability of the vagina to be expanded.
• Obstructed hemi vagina: In rare cases, when the obstructing septum is located in a high position in the vagina, there is risk of scarring.