Vaginal septum

Introduction The vaginal diaphragm is a vaginal plate that evolves from the genitourinary sinus, the vaginal ball to the cephalic end, and is blocked from the bottom-up cavity. It is not penetrated or not completely lumenized. Often occurs in the vagina, the middle third of the junction, but also occurs in any part of the vagina, up to the top of the vagina, close to the cervix. It may be caused by the fact that the end of the renal tube between the two sides is not connected to the urogenital sinus. The vaginal septum is mostly located in the middle third of the vaginal junction, and also occurs in other parts. Complete traverse is rare and can cause vaginal atresia; usually there are small holes in the center or side, which vary in size and affect vaginal fluid and menstrual blood discharge.

Cause

Causes:

During the embryonic period, the predecessor of the female reproductive tract, the Miller tube, is a bilaterally symmetrical bilateral duct. Later, through a series of steps such as midline fusion and septal absorption, a single uterus, cervix and vagina are finally formed on the midline. And still keep the left and right fallopian tubes. This process is completed from about 5 weeks of embryos until 16 weeks. In the meantime, if the progress of the above process is hindered due to the influence of teratogenic factors, different degrees of double uterine double cervix and vaginal malformation may occur.

Pathogenesis:

The specific mechanism of the occurrence of asymmetrical malformations of the vaginal septum is still unclear. The Miller tube is closely related to the occurrence of the middle kidney tube. The development of the Miller tube depends on the development of the middle kidney tube, the development of the middle kidney tube is blocked, and the development of the Miller tube is also abnormal, thus forming a kidney, ureter and vaginal development. Series of asymmetric deformities. The lesions of the vaginal septum are divided into the following three types:

1. Type I: non-porous oblique separation, no holes on the diagonal partition.

2. Type II: There is a perforated slanting partition, and there is a small hole in the slanting partition, and there is often a poor drainage of the sulcus.

3. Type III: non-porous oblique septum combined with cervical fistula, between the two sides of the cervix or between the posterior chamber and the contralateral cervix with fistula formation, there may be poor drainage.

The incidence of the disease is the highest in type II, accounting for about 50%.

an examination

Related inspection

Electronic colposcopy vaginal palpation gynecological routine examination

The thickness of the diaphragm is also very different, some are very thin, like paper, and some are thicker (1 ~ 1.5cm). The interstitial between the two layers of mucosa can be rich in collagen fibers and smooth muscles, and even mixed with kidney-like tissue components. Whether or not there is clinical symptoms, depending on whether there is a small hole in the diaphragm. Complete mechanics are small, most of them have a small hole in the center of the diaphragm. Sometimes they can only pass through the fine probe. The menstrual blood can flow out without symptoms. It is not found until the marriage is due to difficulty in sexual intercourse or the birth of the fetal head. If there is no hole, the symptoms will appear after menarche due to menstrual blood retention. When examining the vaginal septum, first of all, pay attention to whether the mechanic is separated (usually in the central part). If there is a void, the probe can be used to probe the width and depth of the vagina above the small hole for diagnosis. Infertility caused by vulvar and vaginal diseases accounts for 1% to 5% of infertility. The vagina is a receptor for sexual intercourse and semen. Some vulvar, vaginal organic or functional diseases affect the entry and storage of semen or sperm in the vagina, or infertility due to changes in the environment that affect the function of normal sperm.

Differential diagnosis

Differential diagnosis of vaginal diaphragm confusing symptoms

It should be differentiated from hymen atresia: it is not difficult to identify according to symptoms and gynecological examination. However, if it is completely occluded, its symptoms are similar to those of the hymen. Hymen atresia: The shape and size of the hymen hole and the thickness of the membrane vary from person to person. Generally, the hymen hole is located in the center, which is in the shape of a half moon. Occasionally, there is a septum. The hymen hole is divided into two halves, which are called the septum or the two-hole hymen. There is also a membrane in the form of a sieve covering the vaginal opening, which is called a sieve-like hymen. If the hymen pleats are over-developed, it is a non-porous hymen, which is a hymen atresia, which is more common in female genital dysplasia.

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