Congenital vaginal obstruction in young girls: need for standard post-operative dilatation protocol

Abstract

Background: Congenital vaginal obstruction is a rare disorder in which there is blockage of the vaginal tract during the developmental stage and subsequently leading to accumulation of secretions and or menstrual blood. Surgical relief of obstruction is an effective treatment. Ensuring patency of the tract following surgery in young girls not sexually active can be challenging.Methods: This is a 10-years retrospective analytical study of cases of congenital vaginal obstruction in young girls seen in two centres from February 2007 to January 2017. Data retrieved from the case notes included age at presentation, presenting features, prior intervention, diagnosis, surgery performed, vaginal dilatations, outcome, duration of follow-up. Data was subjected to simple statistical analysis.Results: Eight patients met the inclusion criteria. The age range was 7 to 15years with a median of 12years. The cause of obstruction was transverse vaginal septum in 5 cases, imperforate hymen 2, vaginal hypoplasia 1. Three of the patients had no dilatation post operatively and of these, two came back with recurrent obstruction and hematometra. The third one was a case of imperforate hymen and did not develop stenosis despite not being dilated. There were no mortalities.Conclusions: The occurrence of recurrent obstruction following surgical treatment of congenital vaginal obstruction is high. Post-operative dilatation reduces incidence of recurrence.