Vaginal Septum Resection (Müllerian Anomaly Repair)
Precise excision and mucosal reconstruction to open the vaginal canal, relieve pain or obstruction, and support healthy function.
A vaginal septum is a congenital partition of tissue running across (transverse) or along (longitudinal) the vaginal canal. It can cause difficulty with tampons, pain with penetration, obstructed menstrual flow, recurrent infections, or challenges during exams and childbirth. Vaginal septum surgery removes the extra tissue and reconstructs the mucosa edge-to-edge to create a single, open canal. We individualize the plan based on imaging, associated Müllerian differences, and your goals for comfort, sexual activity, and future pregnancy.
Fast Facts About Vaginal Septum Surgery
Outpatient procedure; done under anesthesia with delicate, layered closure
Used for transverse (across) or longitudinal (side-by-side) septa
Relieves blockage, dyspareunia, tampon difficulties, and exam challenges
Mucosa is sutured to prevent re-adhesion and preserve elasticity
Often coordinated with pelvic MRI/ultrasound to map anatomy
Who It May Help
- Primary amenorrhea or severe cramps from obstructed flow (hematocolpos) with a transverse septum
- Pain with intercourse, tampon insertion, or pelvic exams
- Difficulty with menstrual products or recurrent discharge/infections behind a septum
- Planned pregnancy or delivery where a septum may complicate labor
- Longitudinal septum causing a "double vaginal canal" with discomfort or functional issues
How It Works
After confirming anatomy with exam and imaging, we gently expose the septum and inject local anesthetic with epinephrine for precision and hemostasis. The septum is incised and excised in a controlled fashion. For transverse septa, we connect the upper and lower vaginal segments; for longitudinal septa, we remove the partition along its length. The key step is suturing healthy mucosa edge-to-edge with fine, absorbable stitches to create a smooth canal and reduce the risk of restenosis or scarring. A soft stent or mold is used in select cases.
Candidacy & Alternatives
Good candidates have symptoms, obstruction, or anticipated obstetric challenges related to a septum. We typically optimize any infections first and coordinate imaging to evaluate the uterus, cervix, and kidneys for associated Müllerian differences. Alternatives depend on severity and goals: observation for asymptomatic, non-obstructive septa; sexual positioning/comfort strategies; or timing surgery before anticipated intercourse, IUD placement, or pregnancy. We align the plan with your preferences for recovery, intimacy, and family building.
Transverse vs. Longitudinal Septum
Transverse Septum
- Horizontal tissue partition that may block menstrual flow
- Often presents with pain/amenorrhea if obstructing
- Repair connects two segments and opens the outflow
- Post-op dilation may be recommended to maintain patency
Longitudinal Septum
- Vertical partition creating two channels side-by-side
- Often causes tampon difficulties or penetration pain
- Excision unifies the canal with mucosal re-approximation
- May be coordinated with obstetric plans to avoid labor issues
What to Expect
Most procedures take 45–90 minutes. You go home the same day in most cases. Expect mild soreness and spotting for several days. We recommend avoiding intercourse, tampons, swimming, and hot tubs until cleared—often 2–4 weeks depending on the depth of repair. If a stent or mold is placed, we will give specific care instructions. Some patients benefit from pelvic floor physical therapy as part of comfortable return to activity.
Safety & Considerations
Typical effects include temporary soreness, swelling, and light bleeding. Uncommon risks are infection, hematoma, scarring, restenosis, or injury to nearby structures. Careful mucosal suturing helps preserve elasticity and decrease recurrence. We discuss pain control, gentle hygiene, stool-softening strategies to reduce strain, and—when appropriate—graduated dilation or pelvic floor therapy during healing.
Before Your Visit
- ✓Complete pelvic imaging (ultrasound and/or MRI) if requested
- ✓Review associated Müllerian differences and kidney anatomy when indicated
- ✓Avoid intercourse and intravaginal products for 24–48 hours pre-op unless instructed
- ✓Arrange a ride home and plan for a few days of lighter activity
- ✓Pick up recommended supplies: peri-bottle, pads, stool softener, and pain meds
Frequently Asked Questions
1Will surgery affect sexual function?
The goal is comfortable, normal function. By removing obstructing tissue and suturing mucosa edge-to-edge, most patients experience improved comfort. We may recommend pelvic floor therapy to support gentle, confident return to intimacy.
2How long is recovery?
Soreness and spotting usually improve within several days. Many resume routine activities within a week, with intercourse and tampon use after clearance—often 2–4 weeks depending on the repair.
3Could the septum come back?
True regrowth is uncommon when mucosa is re-approximated properly. A small risk of scar band or narrowing exists; adherence to aftercare (and dilation when advised) helps maintain openness.
4Do I need imaging before surgery?
Imaging helps map the septum and assess for associated uterine/cervical differences, which can inform surgical planning and future obstetric considerations.
5Will this change my periods?
If a transverse septum blocked flow, opening the canal typically relieves pain and allows normal passage of menstrual blood. Otherwise, cycles generally remain unchanged.
6What about future pregnancy and delivery?
Many patients have healthy pregnancies after repair. If a septum posed potential labor issues, removal may reduce those concerns. We will coordinate obstetric planning as needed.
Relief From Septum-Related Pain or Obstruction
We'll confirm the anatomy, explain the repair step-by-step, and guide recovery so you can return to comfortable, confident function.
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