Study Objective

Transverse vaginal septae (TVS) are congenital, obstructive anomalies of the vagina typically presenting with abdominal pain and amenorrhea. Currently, the literature about surgical management is sparse. Postoperative complications are common. Vaginal dilation either pre- or postoperatively is sometimes recommended, the outcomes of which are poorly described. The aim of this scoping review was to guide surgical planning, namely, timing and postoperative care, to improve surgical outcomes.

Design, Setting, Participants, and Main Outcome Measures

This scoping review followed the Joanna Briggs Institute framework. The population of interest was patients 21 years of age or younger with a TVS. MEDLINE, OVID and CINAHL databases were searched using the subject headings listed herein. Literature written in English and French were included. Excluded were reports on patients with concurrent urogenital anomalies or severe developmental disabilities. The resultant articles were reviewed by 2 independent researchers. A third researcher was used in cases of disagreement. Using a descriptive analytical method, data were extracted from the included articles.

Results

We screened 1441 articles for eligibility; 41 articles met criteria, which described 152 cases of TVS. The most common management was simple vaginal excision. Five studies included outcomes from preoperative dilation, and 11 from postoperative dilation. There were 21 cases of postoperative vaginal stenosis; half (11/21) occurred without postoperative dilation.

Conclusion

The goal of this review was to describe how TVS are managed and provide guidance for management options. Although the literature was sparse, the authors believe that management in a tertiary center, and surgical delay until the patient is ready to participate in vaginal dilation will improve outcomes for patients with TVS. Further prospective studies are needed to guide surgical planning.

中文翻译：

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横向阴道隔膜切除术：技术、时机和扩张的效用。文献综述

学习目标

阴道横隔 (TVS) 是先天性的阴道阻塞性异常，通常表现为腹痛和闭经。目前，关于手术治疗的文献很少。术后并发症很常见。有时建议在术前或术后进行阴道扩张，其结果描述不佳。该范围审查的目的是指导手术计划，即时间和术后护理，以改善手术结果。

设计、设置、参与者和主要结果测量

该范围审查遵循乔安娜布里格斯研究所的框架。感兴趣的人群是 21 岁或以下的 TVS 患者。使用此处列出的主题词搜索 MEDLINE、OVID 和 CINAHL 数据库。包括用英语和法语编写的文学作品。排除了有关并发泌尿生殖系统异常或严重发育障碍患者的报告。结果文章由 2 位独立研究人员审阅。第三位研究人员用于处理分歧的情况。使用描述性分析方法，从包含的文章中提取数据。

结果

我们筛选了 1441 篇文章的资格；41 篇文章符合标准，描述了 152 例 TVS。最常见的处理是简单的阴道切除术。五项研究包括术前扩张的结果，11 项来自术后扩张的结果。术后阴道狭窄21例；一半（11/21）发生在没有术后扩张的情况下。

结论

本次审查的目的是描述如何管理 TVS 并为管理选项提供指导。尽管文献很少，但作者认为，在三级中心进行管理，并在患者准备好进行阴道扩张之前延迟手术将改善 TVS 患者的预后。需要进一步的前瞻性研究来指导手术计划。