{"paper_id":"71fcdc7c-c609-46ef-b39f-cfd67b0bbb25","body_text":"Abstract\nAim\nThe aim of this study was to underline the significance of premenarcheal gynecological examination in patients with transverse vaginal septum that could possibly be complicated with endometriosis.\nDesign\nRetrospective study including the period between January 2008 and December 2010.\nSetting\nSecond Department of Obstetrics and Gynecology.\nPatients\nWe searched our databases regarding cases of hematocolpos caused by transverse vaginal septum.\nMain outcome\nAmong the patients presented with hematocolpos we identified 4 cases caused by transverse vaginal septum.\nResults\nWe present the management of these cases regarding diagnosis, differential diagnosis, and treatment. The mean age of the patients was 13.1 years. All patients presented in our department with hypogastric abdominal pain and hematocolpos. No problems in adrenarche or thelarche were mentioned. The U/S and MRI revealed a normal cystic in the upper part of the vagina––hematocolpos varying from 42 × 26 × 30 to 73 × 55 × 32 mm. Three of the patients had an upper transverse vaginal septum while one had a middle transverse vaginal septum. Only one patient had a concomitant anomaly of the urinary system (ectopic kidney). In our patients, after laparoscopic examination 3 out of 4 patients had findings of endometriosis (2/3 with stage I-minimal endometriosis and 1/3 with stage II-mild endometriosis).\nConclusion\nPhysicians should be aware of transverse vaginal septum in the differential diagnosis of hematocolpos with abdominal pain and primary amenorrhea in the early adolescent years. Early diagnosis could be based on premenarcheal gynecological examination and could lead to correct management in order to avoid the complications of endometriosis (dysmenorrhea or infertility).\nSimilar content being viewed by others\nReferences\nHein K (1984) The first pelvic examination and common gynecological problems in adolescent girls. Women Health 9(2–3):47–63\nCreatsas G, Cardamakis E, Hassan E, Deligeoroglou E, Salakos N, Aravantinos D (1994) Congenital uterine anomalies with obstructed cervix, hemivagina, or both during adolescence: report of 22 cases. J Gynecol Surg 10:159–167\nCrosby WM, Hill EC (1962) Embryology of the Mu¨llerian duct system. Obstet Gynecol 20:507\nCoskun A, Okur N, Ozdemir O, Kiran G, Arýkan DC (2008) Uterus didelphys with an obstructed unilateral vagina by a transverse vaginal septum associated with ipsilateral renal agenesis, duplication of inferior vena cava, high-riding aortic bifurcation, and intestinal malrotation: a case report. Fertil Steril 90(5):2006 e9–e11\nGrowdon W, Laufer M (2008) Uterine didelphys with duplicated upper vagina and bilateral lower vaginal agenesis: a novel Mullerian anomaly with options for surgical management. Fertil Steril 89:693–698\nDeligeoroglou E, Deliveliotou A, Makrakis E, Creatsas G (2007) Concurrent imperforate hymen, transverse vaginal septum, and unicornuate uterus: a case report. J Pediatr Surg 42:1446–1448\nDeligeoroglou E, Makrakis E, Creatsas G (2001) Obstruction of the female genital tract because of vaginal septum in adolescence. J Gynecol Surg 17:49–56\nLaufer MR, Goldstein DP, Hendren WH (2005) Structural anomalies of the female reproductive tract. In: Emans SJH, Laufer MR, Goldstein DP (eds) Pediatric and adolescent gynecology, Lipincott, Philadelphia, pp 334–416\nNussbaum AR, Sanders RC, Jones MD (1986) Neonatal uterine morphology as seen on real-time US. Radiology 160(3):641–643\nBurgis J (2001) Obstructive Müllerian anomalies: case report, diagnosis, and management. Am J Obstet Gynecol 185(2):338–344\nPatton PE, Novy MJ, Lee DM, Hickok LR (2004) The diagnosis and reproductive outcome after surgical treatment of complete septate uterus, duplicated cervix and vaginal septum. Am J Obstet Gynecol 190:1669–1675\nReese KA, Reddy S, Rock JA (1996) Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol 9(3):125–128\nLaufer MR, Goitein L, Bush M, Cramer DW, Emans SJ (1997) Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol 10(4):199–202\nMarsh EE, Laufer MR (2005) Endometriosis in premenarcheal girls who do not have an associated obstructive anomaly. Fertil Steril 83(3):758–760\nSchifrin BS, Erez S, Moore JG (1973) Teen-age endometriosis. Am J Obstet Gynecol 116(7):973–980\nGoldstein DP, deCholnoky C, Leventhal JM, Emans SJ (1979) New insights into the old problem of chronic pelvic pain. J Pediatr Surg 14(6):675–680\nChapron C, Lafay-Pillet MC, Monceau E, Borghese B, Ngô C, Souza C, de Ziegler D (2011) Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis. Fertil Steril 95(3):877–881\nHollander MH, Verdonk PV, Trap K (2008) Unilateral renal agenesis and associated Müllerian anomalies: a case report and recommendations for pre-adolescent screening. J Pediatr Adolesc Gynecol 21(3):151–153\nPhilbois O, Guye E, Richard O, Tardieu D, Seffert P, Chavrier Y, Varlet F (2004) Role of laparoscopy in vaginal malformation. Surg Endosc 18(1):87–91\nNazir Z, Rizvi RM, Qureshi RN, Khan ZS, Khan Z (2006) Congenital vaginal obstructions: varied presentation and outcome. Pediatr Surg Int 22(9):749–753\nBallweg ML (2003) Big picture of endometriosis helps provide guidance on approach to teens: comparative historical data show endo starting younger, is more severe. J Pediatr Adolesc Gynecol 16(3 Suppl):S21–S26\nSanfilippo JS, Lara-Torre E (2009) Adolescent gynecology. Obstet Gynecol 113(4):935–947\nLaggari V, Diareme S, Christogiorgos S, Deligeoroglou E, Christopoulos P, Tsiantis J, Creatsas G (2009) Anxiety and depression in adolescents with polycystic ovary syndrome and Mayer-Rokitansky-Küster-Hauser syndrome. J Psychosom Obstet Gynaecol 30(2):83–88\nConflict of interest\nNone.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nDeligeoroglou, E., Iavazzo, C., Sofoudis, C. et al. Management of hematocolpos in adolescents with transverse vaginal septum. Arch Gynecol Obstet 285, 1083–1087 (2012). https://doi.org/10.1007/s00404-011-2114-4\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-011-2114-4","source_license":"CC0","license_restricted":false}