Longitudinal vaginal septum

Longitudinal vaginal septum is a congenital malformation of the female reproductive tract in which a fibrous or fibromuscular wall runs lengthwise along the vaginal canal, partially or completely dividing it into two passages. This septum forms during embryonic development due to incomplete fusion or failed resorption of the Müllerian (paramesonephric) ducts. The condition primarily affects the reproductive system and may occur as an isolated anomaly or in association with other Müllerian duct anomalies such as uterus didelphys, bicornuate uterus, or septate uterus. Some patients may also have associated renal anomalies. Many individuals with a longitudinal vaginal septum are asymptomatic and may not be diagnosed until adolescence or adulthood. When symptoms do occur, they can include dyspareunia (pain during intercourse), difficulty with tampon insertion or use, obstructed menstrual flow (particularly if the septum is complete or obstructing), dysmenorrhea, and complications during vaginal delivery such as prolonged labor or vaginal lacerations. In cases where one side of the septum is obstructed, patients may present with hematocolpos (accumulation of menstrual blood in the vagina), pelvic pain, or a pelvic mass. Diagnosis is typically made through pelvic examination, often supplemented by imaging studies such as pelvic ultrasound or magnetic resonance imaging (MRI) to evaluate for associated uterine or renal anomalies. Treatment is surgical excision (resection) of the septum when the patient is symptomatic or when the septum causes obstetric complications. The procedure is generally straightforward with excellent outcomes. Asymptomatic patients who do not experience difficulties may not require intervention, though awareness of the condition is important for reproductive planning and obstetric management.

Inheritance

Sporadic

Usually appears on its own, not inherited from a parent

Age of Onset

Variable

Can begin at different ages, from infancy through adulthood

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