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The vagina normally forms as two tubes meeting in the midline with fusion resulting in the creation of a single vagina. At times there are fusion abnormalities which result in a complete vaginal septum which is a wall running vertically up the vagina, essentially creating two vaginas. A woman may identify that she has a complete vaginal septum when she utilizes a tampon and identifies that she still has blood coming from the vagina even with the tampon in place. She may thus elect to use two tampons, one in each vagina. Alternatively she may notice that the vaginal orifices are too small to insert a tampon. Other women have no symptoms from a complete vaginal septum and with sexual activity the vaginal septum may be torn, thus creating one vagina. Other women notice that during sexual activity a penis will go towards one side or the other due to the fact that one side of the vagina may be larger than the other side.
A complete vaginal septum can be surgically resected. During a resection of a complete vaginal septum, the entire fibrous wall of the septum be removed. The gynecologist should be aware that if the entire septum is not removed there may be a fibrous band of tissue running on the top and bottom of the vagina. This could result in discomfort with sexual activity. It is thus my approach that the entire septum is removed and the normal vagina on both sides of the preexisting septum are brought together to create a normal texture to the vagina.
Women with a complete vaginal septum also have duplication of the upper reproductive tract and thus have two uteri and two cervices.
For more information go to the Center for Young Women's Health website.
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