A longitudinal vaginal septum is a congenital abnormality of the vagina where it is divided into two parallel cavities by a septum.
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Clinical presentation
It is usually asymptomatic unless obstructed, in which case it may cause cyclic pelvic pain. Amenorrhoea may occur if both cavities are obstructed 1.
Epidemiology
Associations
A longitudinal vaginal septum typically arises with other Müllerian duct anomalies such as a septate uterus or uterus didelphys 2. However, it can also arise as an isolated anomaly 3.
Pathology
It is due to failure of lateral fusion/reabsorption of the paired Müllerian ducts during development of the vagina.
Radiographic features
It may be difficult to diagnose in the absence of obstruction.
MRI
T2-weighted images demonstrate a hypointense septum (relative to the hyperintense secretions/blood) with two hemivaginas present 1,3.