Vertical/Complete Vaginal Septum

What is a vertical or complete vaginal septum?

If your daughter has a vertical or complete vaginal septum, she has a wall of tissue running down the length of the vaginal canal, partitioning the space into two vaginas.

Your daughter may realize she has duplicate vaginas when she inserts a tampon during her period and blood still leaks from her vagina. She may try two tampons and find that one vagina is too narrow to fit it in.

Some women have no symptoms of a vertical or complete vaginal septum. During sexual activity, the septum may tear and create one vagina. She may find that her partner's penis will always fall to one side or the other since one side of the vagina may be larger.

A vertical septum may not need to be removed unless it is causing issues, such as difficulty with tampons or pain during sexual activity. Women born with a vertical or complete vaginal septum also have duplications in the upper reproductive tract, meaning that she will have two cervices and two uteri.

What are the symptoms of vertical or complete vaginal septum?

Common symptoms include:

  • pain upon inserting a tampon
  • menstrual blood leaks out even with a tampon inserted

How will vertical or complete vaginal septum affect my daughter's sex life and fertility?

Having a vertical or complete vaginal septum may not affect her sexual life at all. However, some women with a vertical septum experience pain during sex.

Women with a vertical septum can have a normal reproductive life. But because there are two uteri and two cervices, there is a higher risk for premature delivery or breech presentation (when the baby's feet come out first), which usually requires a Caesarean section.

Women with two cervices need a pap smear from both the left and right cervix.

What causes vertical or complete vaginal septum?

A vertical or complete vaginal septum forms during embryological development when the tubes that eventually become a vagina don't fuse together properly. The cause of this genetic abnormality is unknown.

How is vertical or complete vaginal septum diagnosed?

During an examination, your daughter's gynecologist can confirm that a wall of fibrous tissue is partitioning the vagina into two canals.

What is the treatment for vertical/complete vaginal septum?

A surgical procedure is performed to resect or remove the fibrous tissue dividing your daughter's vagina.

The surgery needs to remove the entire septum. If all the tissue isn't removed, there could be a band of tissue running along the top and bottom of the vagina, and this may make sex uncomfortable. This is why the gynecologist at Boston Children's will remove the entire septum and bring the two sides of the vagina together to create a normal vaginal texture.

How we care for vertical or complete vaginal septums

At the Boston Children's Hospital Division of Gynecology and Center for Congenital Anomalies of the Reproductive Tract, an interdisciplinary team of pediatricians, gynecologists, urogynecologists, and colorectal surgeons will work to find the best treatment for your daughter's vertical or complete vaginal septum.