TRANSVERSE VAGINAL MEMBRANE TREATED BY RAIL-ROAD TECHNIQUE USING FOLLY'S CATHETER WITHOUT DISRUPTING THE HYMEN

Layla J. Hussein (DGO, MD. ART) and Mohamad Theyab Hamad Hussei (MRCS)*

ABSTRACT

Background: Genital outflow tract obstruction is a rare cause of primary amenorrhea. Transverse vaginal septum is a rare condition that results from abnormalities in the vertical fusion between the vaginal components of the Mullerian ducts and the urogenital sinus. If the septum is complete, the menstrual flow will be obstructed causing primary amenorrhea. We present a case of 12-year old girl presented by her family to the obstetric and gynaecological outpatient of Al-Batool teaching hospital with acute lower abdominal pain for one day duration. History revealed severe lower abdominal pain for the last day with normal bowel motion, no vomiting, no urinary complaint, and no fever. There was no previous history of such pain. Gynaecological history revealed no previous menstrual cycle. Vital signs were normal. Ultrasound showed cystic mass (5x7) cm between the bladder and the cervix. The patient prepiared for laparotomy. Pfannenstiel incision made, the pelvis explored, both ovaries were normal and a cystic mass involving the upper vagina was found. Rail-Road Technique ( that it is used for repair of urethral injury ) using a 24 gage Folly's catheter passed through the hymen then through the transvaginal membrane to be placed above the membrane, kept for 2 weeks, after that the Folly's catheter was removed. The patient continued experiencing normal menses without any problem for the last five years. For soscial reasons, the surgical excision of the transverse vaginal membrane waited to be performed when the patient got married. Conclusion: Rail-Road Technique inserting a Folly's catheter above a congenital transverse vaginal membrane is good option in areas where disrupting the hymen is refused before marriage.

Keywords: Transverse vaginal septum, Foley catheter.