The present study aims at:

A. The main outcome is to compare preoperative and postoperative visual analog scale VAS from 0 to 10 of maximum perceived pain in ladies with OMAs.

1. description of clinical presentation and percentage of OMAs in relation to other Mullerian anomalies
2. description of different subtypes and its percentage.
3. description of the corrective procedures and their short-term outcomes.

Obstructive Mullerian anomalies (OMAs) represent a real challenge in diagnosis and treatment, its incidence is not yet recognized. Care givers and gynecologist should be aware with its clinical presentation to avoid its delayed diagnosis and misdiagnosis. In addition, delayed diagnoses may result in retrograde menstruation, recurrent cyclic pains, chronic pelvic pains, poor quality of life and threats to future fertility.

Cases with complete obstructive Müllerian anomalies (C-OMAs) classically present with recurrent cyclic pains at puberty and their diagnosis is usually established easily. However, cases with Hemi obstructive anomalies (H-OMA) usually present with progressive dysmenorrhea and delayed diagnosis may result in pelvic adhesions, progressive hematosalpinx and endometriosis which directly threats natural future fertility. H-OMAs may results from obstructing uterine septa or unilateral cervical obstruction in a double uterus. Also, it may result from obstructing longitudinal vaginal septa in cases with double uterus, septate uterus or hybrid septate uterus .

A hybrid uterine anomaly is relatively a recent term that described the coexistence of septate and bicornuate uterus together. Pure septate uterus has a convex or flat fundus, when there is any fundal depression, it is termed hybrid septate uterus.

Pain with or without amenorrhoea is the main presentation of OMAs. Surgical correction should improve these symptoms. To the best of our knowledge there is no published prospective trials compared visual analog scale VAS in ladies with OMAs before and after surgical correction.

Inclusion Criteria:

• All cases with OMAs or H-OMAs

Exclusion Criteria:

• Cases who refuse to participate in the study. 2.Cases who underwent previous surgical repair for their OMA or H-OMA.

demographic data will be collected about age, marital status, menarche, parity, consanguinity and family history.

detailed history: about complaint and presenting symptoms will be obtained as delayed menarche, cyclic pain, abdominal distention, dull aching abdominal pain, dyspareunia and infertility physical examination:

• general examination for secondary sexual characters, other anomalies
• abdominal examination for abdominal mass, tenderness
• genital examination by inspection for bulging hymen, per-vaginal examination
• per- rectal examination investigation : CBC,, transvaginal, per-rectal, 3D abdominal ultrasonography

Diagnosis:

Anomalies will be categorized according to ESHRE classification 2016 Surgical procedure: follow up for the patient for three months for symptoms improvement and any complications.