Design: Single Patient

Setting: Tertiary Gynaecological Endoscoy Centre

Patients or Participants: One

Interventions: Use of Sonography and Hysteroscopy to correct the hematometra and create the distal vagina in single sitting . With the MRI showing the distance between the perineum to the Hematocolpos was 2.65 cms only sonography control was used to reach the atretic part of the vagina and the hematocolpos was drained using a Verees needle. Under Hysteroscopic guidance the vaginal mucosal opening was extended and the mucosal membrane anteriorly and posteriorly pulled down and sutured to the perineum anteriorly and posteriorly respectively. The patency was maintained with a glove finger vaginal mould. Re hysteroscopy done after 8 days and a drain tube kept in the new vaginal space for six weeks .

Measurements and Main Results: The hematocolpos and hematometra with creation of the distal atretic portion of the vagina was created in a single sitting

Conclusion: Identification of the cause for the hematocolpos hematometra is important for correcting the pathology in single sitting to avoid repeated surgeries in distal vaginal atresia.