Excision of vaginal septum
CPT4 code
Name of the Procedure:
Excision of Vaginal Septum
Common names: Vaginal septum removal, Septal excision
Medical terms: Colpectomy of vaginal septum, Vaginal septum resection
Summary
The excision of a vaginal septum is a surgical procedure to remove a band of tissue that divides the vaginal canal. This congenital anomaly, known as a vaginal septum, can cause complications such as painful menstruation, difficulty with intercourse, and challenges during childbirth.
Purpose
The procedure addresses the presence of a vaginal septum, which can cause obstruction, pain, and complications in menstrual flow, sexual activity, and childbirth. The goal is to restore normal vaginal anatomy, alleviate symptoms, and prevent future complications.
Indications
- Painful menstruation (dysmenorrhea)
- Difficulty with sexual intercourse
- Obstructed menstrual flow
- Complications during childbirth
- Recurrent vaginal infections due to obstructed flow
- Routine assessment during gynecological exam revealing a septum
Preparation
- Fasting for at least 8 hours prior to the procedure if general anesthesia is planned.
- Adjustments to medications may be required; patients should discuss current prescriptions with their healthcare provider.
- Pre-procedure assessments including pelvic exam, ultrasound, and possibly MRI to evaluate the septum's extent and location.
Procedure Description
- The patient is positioned in a lithotomy position (lying on the back with legs raised).
- General or regional anesthesia is administered for pain control.
- The surgeon inserts a speculum to visualize the vaginal canal.
- The septum is identified, and surgical instruments, such as scissors or a scalpel, are used to excise the septum carefully.
- The surgical area may be sutured to ensure proper healing.
- Tools used include speculum, scalpel/scissors, suturing materials, and surgical sponges.
- Post-operative care involves monitoring in a recovery room.
Duration
The procedure typically takes about 30 minutes to 1 hour, depending on the complexity.
Setting
The procedure is generally performed in a hospital or outpatient surgical center.
Personnel
- Gynecologic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection
- Bleeding
- Pain or discomfort post-procedure
- Scarring
- Rarely, damage to surrounding tissues or structures
Benefits
- Relief from painful menstruation
- Enhanced sexual function
- Improved menstrual flow
- Reduced risk of infections and complications during future pregnancies or childbirth
- Benefits are typically realized immediately after recovery, though healing varies.
Recovery
- Patients usually go home the same day.
- Pain management with prescribed medications.
- Avoid strenuous activities and sexual intercourse for approximately 4-6 weeks.
- Follow-up appointment within 1-2 weeks post-procedure to monitor healing.
Alternatives
- Observation with regular monitoring if the septum is asymptomatic.
- Non-surgical management for mild symptoms (e.g., hormonal therapy to control menstruation).
- Each alternative has limitations and varying degrees of effectiveness compared to surgical excision.
Patient Experience
- During the procedure, anesthesia ensures patients feel no pain.
- Post-procedure, some discomfort and mild pain are expected, managed with prescribed medications.
- Full recovery involves abstaining from strenuous activities and following care instructions.
- Most patients report significant relief from symptoms and overall improvement in quality of life after recovery.