Background: Uterus didelphys with imperforate hemivagina is a rare Müllerian anomaly occurring between the 12^th and 16^th weeks of gestation. Currently the excision of the vaginal septum is considered the treatment of choice for cases of obstructed hemivagina, conventionally performed using scissors and scalpel. The hysteroscopic excision of vaginal septum in those with uterus didelphyshas several advantages including feasibility, availability, effectiveness and preservation of virginity.

Objectives: We aimed to report the benefits of hysteroscopic resection of vaginal septum in patients with uterus didelphys and obstructed hemivagina.

Patients and Methods: This cross-sectional study was performed in Shiraz University of Medical Sciences including 11 patients with uterus didelphys and obstructed hemivagina. Hysteroscopic resection, of vaginal septum was performed for all patients and the outcomes were observed.

Results: The mean age of the patients was 14.73 ± 2.3 (range 13-16) years. The most common symptom was cyclic dysmenorrhea. The vaginal septum was resected safely in all of the patients. The symptoms including cyclic dysmenorrhea and hematometra resolved after 3 months.

Conclusions: Hysteroscopic resection of the vaginal septum is an available, feasible, convenient, and effective tool in the management of uterus didelphysplus obstructed hemivagina which enables the surgeon to preserve the hymen integrity.