A vaginal septum is a band of fibrous tissue that divides the vagina either partially or completely. It is a congenital condition (present from birth). There are two main types:
- Longitudinal Septum: A vertical wall that divides the vagina into two channels. It may be associated with a double uterus (uterus didelphys).
- Transverse Septum: A horizontal wall that can block part of the vagina, sometimes preventing menstrual flow.
Surgery (Septum Resection) is performed to remove this tissue to:
- Allow for normal sexual intercourse.
- Enable the use of tampons.
- Restore normal menstrual flow (if blocked).
- Facilitate childbirth.
- Relieve pain or discomfort.
Preparing for Surgery
Pre-operative Assessment
- Pelvic Examination: Your gynaecologist will assess the septum’s location and size.
- Imaging: An ultrasound or MRI may be used to understand the septum’s structure and check for any associated uterine abnormalities.
- Detailed Discussion: You will talk with your surgeon about the goals of surgery, the technique, risks, and what to expect during recovery.
Before Surgery
- Medications: Inform your doctor of all medicines. You may need to stop blood thinners or certain supplements before surgery.
- Fasting: You will be instructed to have no food or drink (fast) for 6–8 hours before the procedure.
- Support: Arrange for someone to drive you home and assist you for the first 24-48 hours.
- Counselling: If you have concerns about body image, sexual function, or fertility related to the condition, discussing them with your gynaecologist can be helpful.
During the Procedure
- Anaesthesia: The surgery is usually performed under general anaesthesia (you are asleep). Sometimes spinal or epidural anaesthesia is used.
- Duration: Typically takes 30 minutes to 1.5 hours, depending on the septum’s thickness and complexity.
- The Procedure: The surgeon will carefully cut and remove the fibrous septal tissue. The healthy vaginal lining on each side is then stitched together using dissolvable stitches to create a single, normal-calibre vaginal canal.
- Hospital Stay: This is often a day-case procedure, meaning you can go home the same day. In some cases, an overnight stay may be recommended.
Recovery After Surgery
Immediate Post-Op Care (First 1-2 Weeks):
- Pain: You can expect some cramping or discomfort. This is managed with prescribed pain relief or over-the-counter medications like paracetamol or ibuprofen.
- Bleeding/Discharge: Light bleeding or a brownish discharge is normal for 7-14 days. Use pads, not tampons.
- Wound Care: Keep the area clean and dry. Gently wash with warm water and pat dry. Avoid baths, swimming, and hot tubs until your doctor advises it’s safe (usually after 2-4 weeks).
- Activity: Rest for the first few days. Avoid heavy lifting, vigorous exercise, and prolonged sitting for 2-4 weeks. Driving is usually not advised for 1-2 weeks.
Returning to Normal Activities:
- Sexual Intercourse: You must wait until you are fully healed, typically at 6-8 weeks post-surgery, and after your post-operative check-up.
- Tampon Use: Avoid using tampons until your doctor confirms healing is complete, usually at your follow-up appointment.
- Work: You can often return to desk work within a week. Jobs requiring physical exertion may require 2-4 weeks off.
Long-Term Considerations
- Healing: Complete internal healing takes several weeks. Scar tissue will soften over 3-6 months.
- Follow-up: You will have a post-operative check-up (4-6 weeks after surgery) to ensure healing is progressing well.
- Sexual Function: The goal is to improve comfort and function. Some initial tenderness is common but should resolve.
- Childbirth: Removing the septum does not typically affect the ability to have a vaginal delivery. If you have an associated uterine abnormality, your pregnancy may be considered higher risk and require specialist monitoring.
Risks and Potential Complications
While generally safe, all surgeries carry some risks:
- Bleeding or Infection.
- Injury to nearby structures (e.g., bladder, rectum) – this is very rare.
- Pain during intercourse (dyspareunia) if scarring occurs.
- Recurrence of the septum (very uncommon if fully resected).
- Anaesthesia-related risks.
Frequently Asked Questions (FAQs)
Q: Is this surgery considered cosmetic?
A: No. It is a reconstructive or functional surgery to correct a developmental anomaly and allow for normal bodily functions.
Q: Will this surgery affect my fertility?
A: The surgery itself does not affect fertility. However, if you have a uterine abnormality associated with the septum (like a double uterus), it may impact pregnancy outcomes.
Q: How long do the results last?
A: The results are usually permanent. The tissue does not grow back.
Q: Are there non-surgical options?
A: For a fibrous septum, surgery is the only definitive treatment. A very thin, membranous septum can sometimes be treated in the clinic, but this is less common.
eGynaecologist Advice
- You should seek psychological support if needed to help with decision making process and manage feelings about procedure when you are going to have vaginal septum surgery.
- You must inform you gynaecologist if following this procedure, you report soaking a pad in an hour, have signs of infection including fever, chills, or foul-smelling discharge or have difficulty or pain when passing urine.
