What Is Vaginal Septum?

  • Aleena Rajan Master Of Public Health (MPH) -University of Wolverhampton

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Unlocking the mystery of the Vaginal Septum: Navigating the intricacies of this unique anatomical variation and empowering people assigned female at birth (AFAB) with knowledge and options for a healthier, happier life.

Introduction 

"Vaginal Septum" is a phrase that integrates a story of anatomical variation and significant health implications into the intricate fabric of the female reproductive system. The vaginal septum, which is an intriguing but frequently misinterpreted feature of gynaecological anatomy, is described as a barrier or wall within the vaginal canal. Congenital or acquired, this condition has the potential to have a severe negative influence on one's ability to procreate and general well-being. The vaginal septum is fundamentally a structural variance within the vagina, and each person will experience it differently in terms of size and position. Even though some people AFAB may be completely unaware of this distinctive physical trait, for others, it might pose serious clinical problems and raise significant concerns regarding fertility, sexual health, and emotional well-being.1

Both inherited traits and acquired diseases can be linked to the development of a vaginal septum. Genetic factors or aberrant developmental patterns during embryonic growth frequently cause congenital vaginal septum. The complexity of this issue is highlighted by the fact that an acquired septum, on the other hand, might result from trauma, injury, or surgical procedures. Understanding the subtle signs of a vaginal septum and using different diagnostic techniques are necessary to detect its presence. Healthcare experts negotiate a difficult terrain to locate and evaluate the impact of the septum, ranging from physical tests to cutting-edge imaging methods like ultrasound and MRI. 

This article takes readers on a tour through the complex world of the vaginal septum, examining its anatomy, causes, diagnostic techniques, and the variety of potential treatments. It strives to demystify this frequently disregarded facet of women's health and serves as a useful tool for people, medical professionals, and anyone else interested in learning more about the intricate details of female reproductive anatomy. Join us as we reveal the vaginal septum's layers, educating women and promoting a greater understanding of the intrinsic individuality in every person AFAB's body.2

Anatomy of vaginal septum

A vaginal septum is a structural difference which can appear in various sizes and forms and is located within the vaginal canal, constituting a partition or wall. Its presence could go unnoticed in some people, but for others, knowing its anatomy is essential for providing complete treatment. Both inherited and acquired factors can affect the formation of the vaginal septum, which is normally made up of fibrous tissue.3 Congenital septa result from genetic predispositions or abnormal developmental patterns during embryonic development, and they are present from birth. The plasticity of the vaginal anatomy is shown by the fact that the acquired septum can also develop because of trauma, injury, or surgical procedures. The vaginal septum is spread out along the length of the vagina in different places. The intricacy of gynaecological anatomy is exacerbated by its variability, calling for an individualised approach to diagnosis and therapy. When navigating the complexities of someone's reproductive health, healthcare professionals must have a solid understanding of the anatomy of the vaginal septum. This understanding can help them provide more individualised treatment and promote a greater understanding of the diversity that exists in the female body.4

Causes and development of vaginal septum

Vaginal septum development is a dynamic interaction of congenital and acquired variables that helps to shape the complex topography of female reproductive anatomy. Both healthcare experts and others dealing with the ramifications of vaginal septum must comprehend the condition's causes and history.

Congenital conditions

  1. Genetic Influences: Genetic influences play a major role in the formation of congenital vaginal septum, which frequently has a hereditary component. A septum may emerge within the vaginal canal as a result of specific gene mutations that affect the female reproductive system's embryonic development.
  2. Developmental abnormalities: Vaginal septa can develop because of anomalies during embryonic development. There may occasionally be a partition inside the vagina due to partial fusion or faulty development of the Müllerian ducts, the progenitors to female reproductive organs.5

Acquired factors

  1. Trauma or Injury: Injuries or trauma to the pelvic area might later result in the development of vaginal septum. Such events may cause the vaginal canal to become divided because of the development of scar tissue or fibrous bands.
  2. Surgical Techniques: A vaginal septum can unintentionally develop because of some gynaecological procedures, notably those that remove or modify reproductive organs. Structures in the vaginal anatomy may change because of operations like hysterectomy or surgery to treat reproductive health disorders.6

Symptoms of vaginal septum

Individuals may have a wide range of symptoms from a vaginal septum, and occasionally they may not experience any symptoms at all. When symptoms do materialise, they frequently take the following forms:

  1. Menstrual Irregularities: People who have a vaginal septum may have irregular menstrual periods. This can involve irregularly long or heavy periods, as well as problems using tampons or menstrual cups.
  2. Pain During Intercourse: People with vaginal septa may experience pain or discomfort during sexual activity. During penetration, the septum's presence might cause friction, discomfort, or even severe agony.
  3. Recurring urinary tract infections (UTIs): A vaginal septum may interfere with the normal flow of urine, raising the possibility of an elevated risk of UTIs. Because of the changed anatomy, bacteria may collect in pockets or other areas.
  4. Tampon Use Difficulties: People with vaginal septa may find it difficult to insert and remove tampons. Tampon insertion may be painful or challenging if the septum blocks the natural path.
  5. Fertility Problems: In some instances, a vaginal septum may be a factor in reproductive issues. The changed anatomy may interfere with a fertilised egg's ability to implant or the usual course of sperm.7

Diagnosis of vaginal septum

The following techniques are used by healthcare professionals to detect and evaluate the presence of a vaginal septum:

  1. Medical History: The first step in the diagnostic process is to compile a thorough medical history. Healthcare professionals enquire about a patient's menstrual history, sexual history, and any symptoms that might be connected to either.
  2. Physical Examination: To determine the architecture of the vaginal canal, a pelvic examination is performed. To see the vagina and spot any anomalies, a speculum is used in this procedure. To find a septum, the healthcare professional may palpate the vaginal walls.
  3. Imaging Techniques: To confirm the diagnosis and offer thorough information regarding the size and position of the vaginal septum, advanced imaging tests are frequently used. Ultrasound, magnetic resonance imaging (MRI), or other imaging techniques may be used for a more thorough evaluation.
  4. Hysteroscopy: A hysteroscopic examination may be advised in specific circumstances. To see the internal features, especially the vaginal septum a thin, illuminated tube (hysteroscope) must be inserted into the vagina.8

Treatment of vaginal septum

The symptoms, reproductive objectives, and size/location of a vaginal septum all affect how the septum is treated. When using conservative methods, observation and ongoing monitoring may be necessary, particularly if the septum is tiny and asymptomatic. Surgical intervention is frequently taken into consideration when symptoms are severe. The septum can be removed or resected surgically, usually by a minimally invasive treatment like hysteroscopy.

For more complicated situations, reconstructive surgery may also be required to return the natural vaginal anatomy. Discussions between the patient and their healthcare provider are vital in establishing the best course of action because treatment choice is highly individualised. Follow-up care after treatment promotes complete recovery and takes care of any lingering issues or symptoms.9

Risk and complications of vaginal septum

Treatment for a vaginal septum has minor risks and potential problems, even though it is normally safe. Risks associated with surgical procedures, such as septum excision, include bleeding, infection, and adverse anaesthetic reactions. Sometimes, adhesions or scarring might form, which can harm a person's ability to conceive in the future. Additionally, there is a chance of recurrence. 

Due to their complexity, reconstructive procedures aimed at restoring normal vaginal anatomy may have a higher risk profile. Fertility problems might not go away; in rare instances, the operation might accidentally harm nearby structures. It's essential for patients thinking about therapy to discuss any risks and problems fully with their healthcare professionals. To reduce risks and make sure the best results are achieved, careful preoperative assessment and postoperative monitoring are necessary.10

Summary

In conclusion, a vaginal septum's complexity must be understood and addressed to provide comprehensive women's healthcare. Each case is unique and calls for individualised diagnostic and treatment strategies due to the complex interaction of congenital and acquired factors. Even though some people may continue to be asymptomatic, the potential consequences for reproductive health and general well-being call for cautious consideration. The vaginal septum can now be precisely identified and assessed because of improvements in diagnostic tools, including hysteroscopy and imaging modalities. 

Treatment options enable people to manage symptoms and improve the success of reproduction, ranging from conservative approaches to surgical interventions. Open communication with healthcare professionals ensures that decisions are made with knowledge of the risks and potential problems connected with interventions. 

In the end, raising people's knowledge of vaginal septums and educating them about them promotes a supportive healthcare environment, enabling proactive care and empowering patients. Understanding the complexities of this anatomical variance helps us advance a holistic view of women's health that emphasises individualised care and an appreciation of the various components of the female reproductive system.

References

  1. Moegni F, Quzwain S, Rustamadji P. Transverse vaginal septum managed by simple flap surgery technique: A case report. International Journal of Surgery Case Reports [Internet]. 2021 Jun [cited 2023 Oct 6];83:105990. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2210261221004922
  2. Williams C, Nakhal R, Hall‐Craggs M, Wood D, Cutner A, Pattison S, et al. Transverse vaginal septae: management and long‐term outcomes. BJOG [Internet]. 2014 Dec [cited 2023 Oct 6];121(13):1653–8. Available from: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.12899
  3. Saks EK, Vakili B, Steinberg AC. Primary amenorrhea with an abdominal mass at the umbilicus. Journal of Pediatric and Adolescent Gynecology [Internet]. 2009 Feb [cited 2023 Oct 6];22(1):e1–3. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1083318808002453
  4. Rock JA, Zacur HA, Dlugi AM, Jones HW, TeLinde RW. Pregnancy success following surgical correction of imperforate hymen and complete transverse vaginal septum. Obstet Gynecol. 1982 Apr;59(4):448–51.
  5. Beksac MS, Salman MC, Dogan NU. A new technique for surgical treatment of vaginal agenesis using combined abdominal-perineal approach. Case Reports in Medicine [Internet]. 2011 [cited 2023 Oct 6];2011:1–6. Available from: http://www.hindawi.com/journals/crim/2011/120175/
  6. Heinonen PK. Longitudinal vaginal septum. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 1982 Jun [cited 2023 Oct 6];13(4):253–8. Available from: https://linkinghub.elsevier.com/retrieve/pii/002822438290106X
  7. Caliguiri JV. Vaginal Septum, A Cause of Dystocia**The opinions or assertions contained herein are the private ones of the writer and are not to be construed as official or reflecting the views of the Navy Department or the Naval service at large. American Journal of Obstetrics and Gynecology [Internet]. 1957 May [cited 2023 Oct 6];73(5):1132–3. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002937816371885
  8. Haddad B, Louis-Sylvestre C, Poitout P, Paniel BJ. Longitudinal vaginal septum: a retrospective study of 202 cases. European Journal of Obstetrics & Gynecology and Reproductive Biology [Internet]. 1997 Aug [cited 2023 Oct 6];74(2):197–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S030121159700105X
  9. Gupta R, Bozzay JD, Williams DL, DePond RT, Gantt PA. Management of recurrent stricture formation after transverse vaginal septum excision. Case Reports in Obstetrics and Gynecology [Internet]. 2015 [cited 2023 Oct 6];2015:1–5. Available from: http://www.hindawi.com/journals/criog/2015/975463/
  10. Papaioannou G, Koussidis G, Michala L. Magnetic resonance imaging visualization of a vaginal septum. Fertil Steril. 2011 Nov;96(5):1193–4. 

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Aleena Rajan

Master Of Public Health (MPH) -University of Wolverhampton

Dr Aleena is an Ayurvedic Physician with extensive experience in hospital and clinical settings. She holds Indian licenses and board certification in Ayurvedic Medicine. She has worked as a consultant doctor for 3 years and also as Medical Officer for 2 years. She has dedicated her career to providing comprehensive medical care and improving the well-being of her patients. Currently, she is pursuing her postgraduation in public health.

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