The physiology of the "holed" presentation typically stems from a transverse vaginal septum. During embryogenesis, failure of the canalization process between the Mullerian tubercle and the urogenital sinus results in a septum. In a complete obstruction, menstrual blood accumulates, leading to a palpable mass (hematocolpos).
Keep the graft union (the bump where the rose meets the roots) at ground level. holed bella rose