Vaginal septum surgery

As there are more and more vaginal diseases nowadays, and most of them are infertility caused by vaginal diseases, in order to avoid these problems affecting future physical health, everyone should do corresponding prevention and conditioning work in daily life. Comprehensive vaginal surgery is currently a common surgery, and this surgery can be used to solve some infertility problems.

Infertility caused by vulvar and vaginal diseases accounts for 1% to 5% of infertility. The vagina is the receptor for sexual intercourse and semen. Certain organic or functional diseases of the vulva and vagina affect the entry and storage of semen or sperm into the vagina, or affect the function of normal sperm due to changes in the environment, leading to infertility.

This disease can occur in a completely normal uterus or in combination with a double uterus and double cervix. The septum is usually attached to the midline of the anterior and posterior walls of the vagina, runs longitudinally, and can be divided into partial and complete. The latter starts from the cervix and extends to the external opening of the vagina, dividing the vagina into two, forming a double vagina. Occasionally, the septum deviates from the midline and fuses with the side wall of the vagina, forming an oblique vaginal septum. Vaginal septum is generally asymptomatic until it is discovered after marriage when the patient seeks medical attention due to difficulty in sexual intercourse. Some are delayed in delivery because the examination of delayed labor is not yet clear or the diagnosis is unclear, and dystocia with the feet presenting astride the mediastinum may occur. Combined cervical and uterine malformations may be a factor of infertility. The treatment method is simple: just resect and suture the edges.

treat

1. Patients without symptoms may not need surgical treatment for the time being.

2. Surgical treatment.

(1) Mediastinectomy is performed for patients with symptoms.

(2) If labor has already begun and the fetal presenting part is obstructed from descent, the septum can be cut along the midline and slightly trimmed after delivery.

Treatment

1. Circular incomplete vaginal septum: In principle, radial incision plastic surgery is performed, starting with the side wall. When cutting the front wall, a catheter should be inserted into the urethra for guidance; when cutting the back wall, an anal examination should be used for guidance to prevent damage to adjacent organs. I treat hymen occlusion in the same way.

2. Perforated or complete septum: The positional relationship and distance between the septum and the cervix should be clearly explored first. The septum should be carefully incised under guidance and reshaped as appropriate, trimmed to the base of the septum, and interrupted sutures should be used with absorbable sutures to stop bleeding. If the diaphragm is high and the membrane is thick and difficult to suture, a vaginal plug should be placed to dilate the area on the basis of hemostasis, and the area should be covered and packed with gauze containing antibiotic oil. Prevent and control infection during perioperative period. If there are no other infertility factors, normal pregnancy can be achieved after treatment.

Does it affect pregnancy?

Patients with vaginal septum often do not feel any unusual sensations, do not experience menstrual blood retention, and in most cases have no impact on sexual life. No treatment is required. If surgery affects sexual life, a mediastinotomy can be performed. It should be noted that if a person with vaginal septate has a uterine malformation, the side that is involved during sexual intercourse may not ovulate, which may cause fertility problems.

Sometimes the mediastinum deviates to one side, causing the vagina on that side to be closed and menstrual blood to be retained. The vast majority of vaginal septum cases are asymptomatic. Some are discovered only after marriage when the patient has difficulty having sex, while others may not be diagnosed until delivery when the labor progresses slowly. If the mediastinum blocks the discharge of menstrual blood, affects sexual life or hinders childbirth, the mediastinum should be removed during the non-pregnancy period and the wound should be sutured to prevent adhesion.