Vaginoplasty case series at the University College Hospital Ibadan

Abstract

Transverse vaginal septum is a benign condition with the septum occurring at various levels within the vagina; it may occur in the upper third, mid-vaginal or lower third. A report of five cases of transverse vaginal septum managed at the University College Hospital between January, 2006 and December, 2009. Three were cases of congenital transverse
vaginal septum while the other two were cases of acquired transverse vaginal septum. Diagnosis of congenital transverse vaginal septum was made following history of primary amenorrhea, pelvic examination revealing a vaginal septum. In addition, a pelvic mass and ultrasound findings of haematocolpos and haematometria were present in the first case. Diagnosis of acquired vaginal septum was made following history of
secondary amenorrhea, cyclical abdominal pain and pelvic examination findings of gynaetresia and vaginal septum. In all but one, surgical resection of the transverse vaginal septum was performed, followed by lining of the vagina by split thickness skin graft (STSG): the McIndoe-Read operation. All the procedures were performed in conjunction with the Plastic surgeon. They were seen at the Gynaecology clinic post operatively at two weeks, six weeks, three and six months respectively. Four out of the five cases successfully menstruated following surgery. The fifth case was
lost to follow up. The first case was able to achieve successful coitus. None of the cases required blood transfusion nor suffered serious complications such as fistula formation. However, in two cases there was premature expulsion of the mould one of which was due to vaginal infection leading to sloughing and secondary skin grafting.

Key words: Cryptomenorrhoea, haematocolpos, vaginal septum, vaginoplasty.