Resectoscopic excision of the vaginal septum in a virgin with uterus didelphys and obstructed unilateral vagina.

Mullerian anomalies occur in 0.1–0.5% of women [1]. Failure of the paired mullerian ducts to fuse laterally can result in uterus didelphys with obstructed unilateral vagina. This congenital disorder is often associated with renal anomalies, such as ipsilateral renal agenesis, renal dysplasia, a double collecting system, and an ectopic ureter [2–4]. Affected girls may present with low abdominal pain, severe dysmenorrhea, a pelvic or vaginal mass, abnormal vaginal discharge, and intermenstrual bleeding. These symptoms usually appear in adolescent girls after menarche. Because of the small vaginal orifice and relatively high location of the vaginal septum in affected girls with an intact hymen, it is difficult to correct the vaginal anomaly without a hymenectomy. However, young female virgins with this congenital anomaly may have a strong desire to preserve the integrity of their hymenal ring for ethnic or personal reasons. Hysteroscopic resection of the vaginal septum with obstructed hemivagina has been reported to maintain the patient’s virginity [5]. Ultrasound guidance can be used to improve the safety of resectoscopic surgical procedures. [6]. We present the case of a female virgin with this rare syndrome, pyocolpos, and a vertical vaginal septum. She was treated with a minimally invasive resectoscopic operation under transabdominal ultrasound guidance. The integrity of her hymen was preserved after the surgery. A 15-year-old girl visited our department with a 6month history of intermittent low abdominal pain and fever. She denied having any sexual experience. Menarche had occurred at 12 years, with subsequent regular menstrual intervals. A pelvic examination revealed low