pt namrataben 14 yrs.referred from pvt.for transverse vaginal septum trial under g/A done vaginally but unsuccessful. Pt had complained of pain in lower abdomen periodically since last six month and on USG shows collection in genital tract with hematosalpinx.we have done MRI shows more collection in upper vagina,10*10 cm and haematosalpinx with transverse vaginal septum at upper 2/3rd and lower 1/3rd junction but thickness not exactly elicited.uterus bulky with small haematometra.stretched fornix due to haematocolpus.by considering hymen intactness,age of pt,and previous failed vaginal trial I examine pt under anaesthesia P/R done big cystic mass felt may in vagina.small incision kept 2 finger above pubic symphysis 4 cm transverse.per op.it bulky sit over big vaginal collection ,rt.side hematosalpinx with fimbrial block and adhesion present,left side 5*5 cm cyst with thick edematous tube and in mesosalpnx 3*3 cm thick dark blood collection present also adhesion present.I had put incision 1*1 cm on top ant.stretched fornix and suction done all haematocolpus about 700cc.than anatomy somewate clear and rt. And Lt adhesiolysis done and rt side open fimbrial end and suction done on Lt.aspirate cyst ,capsule of cyst removed and with 2-0 vicry 3 stitches taken.and also below salpinx collection removed.both side check for hemostasis.then I had insert middle finger from incision of ant.fornix to vagina press the septum and catch it from below gently dissected it meticullously whole tract open roller pack kept from above and 8 no.Folly's in vagina 15 cc inflation done.then closed ant.fornix incision done. Interseed kept over closed incision.thorough peritoneal lavage given.U/o adequate.pt.well.vaginal catheter for 15 days and adviced to remove vaginal pack after 24 hrs.no bld p/v.in future after marriage vaginoscopy and hyseroscopy adviced.hymen intact post.op.USG after 1 month adviced.skin subcuticular stitch taken.your advice needed guide me further friends.

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Thanks dr Trupti. I think this is the same pt which I referred to u. The pt which I posted earlier on this platform & was labelled as Haematocolpus due to imperforate Hymen.

Nice case.beautifully explored and surgery done .Thanks for sharing,Mam

Thanks madam
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Very meticulously done. Thanks once again.

Welcome madam.yes that is same case.case of haematocolpus,hematosalpinx,transverse vaginal septum.for septum dissection from above guideded downward approach I like and safe for transverse vaginal septum.
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Nice case shared mam

Thanks u dear Dr.sweety
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Very nice case maam Thanx for sharing Wat maybe the cause fr adhesions in such a young girl

It may be like endometriosis to mild level. Really interesting case
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Nice job done, but take care not to reveal the identity of pt, you may invite troubles

OK sir and thanks sir.
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Wonderfully brave of you & inspiring

Thanks madam
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exellent surgery.Thanks for sharing.

Thank madam
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Outstanding mam

Thanks madam
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Thanks Dr Trupti. For sharing d case

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Transverse Vaginal Septum
Endometriosis
Pyosalpinx

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