VAGINAL SEPTUM AND RARE CAUSES OF INFERTILITY WITH ROLE OF MRI BASED ENDOVAGINAL GEL INSTILLATION TECHNIQUE – A USEFUL TOOL IN DETECTION OF OBSTRUCTED VS NON OBSTRUCTED VAGINAL SEPTUM

Syed Shariq ullah

VAGINAL SEPTUM AND RARE CAUSES OF INFERTILITY WITH ROLE OF MRI BASED ENDOVAGINAL GEL INSTILLATION TECHNIQUE – A USEFUL TOOL IN DETECTION OF OBSTRUCTED VS NON OBSTRUCTED VAGINAL SEPTUM

Syed Shariq ullah

Abstract

Objective:

To investigate the accuracy of magnetic resonance imaging (MRI) by using endovaginal gel instillation technique in order to diagnose obstructed vs non obstructed vaginal septum as a cause of infertility.

Methods:

A retrospective, cross-sectional study was performed on 50 infertile patients who had a strong clinical suspicion of vaginal septum based on history and clinical examination comprising bimanual gynecological examination and speculoscopy. MRI was performed on these 50 patients and 08 patients who were diagnosed as vaginal septum were subjected to endovaginal gel instillation technique in order to diagnose its obstructed or non-obstructed type. The data was collected over a period of 01 year; from 01^st January 2017 to 31^st December 2017. The study center was the Department of Radiology, at Liaquat National Hospital, Karachi.

Results:

Out of these 50 infertile patients which were under 40 years, 16 patients (32%) had hydrosaplinx, 8 patients (16%) had hemorrhagic cyst, 7 patients (14%) had endometriotic cyst, 5 patients (10%) had hematocolpos, 4 patients (8%) had bicornuate uterus, 2 patients (4%) had OHVIRA syndrome. Only 08 patients (16%) had vaginal septum out of which 4 patients (8%) had obstructed while 4 patients (8%) had non-obstructed vaginal septum diagnosed on endovaginal gel instillation technique.

Conclusion:

The MR imaging gel instillation technique shown by our single center study is considered to be a useful, beneficial and minimally invasive approach for diagnosing obstructed and non-obstructed vaginal septum. We also believe that this method will be recognized as a superior diagnostic approach in patients suffering from vaginal endometriosis and thus help the gynecologists in planning effective therapeutic strategies.

KEYWORDS: Endovaginal gel instillation, MRI scan

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