Vaginal agenesis is a rare birth defect affecting approximately 1 in 5,000 women. This condition occurs when the vagina does not fully develop. There is a wide variation of the vagina with some with no vagina while some have a short vagina. It is also common to have other reproductive tract anomalies, such as an absent or underdeveloped uterus, or kidney abnormalities.
Symptoms of Vaginal Agenesis
The symptoms of vaginal agenesis are associated with “amenorrhea,” which is the absence of a menstrual period after puberty begins.
Diagnosing Vaginal Agenesis
Vaginal agenesis is often not discovered until around age 15 when a patient notices the absence of the menstrual period and seeks medical attention. Diagnosis involves a physical exam and imaging, typically using ultrasound to check the uterus and ovaries. If needed, an MRI can provide a more detailed view of the reproductive tract.
Treatment of Vaginal Agenesis
Treatment begins for most girls when they are in their teenage years, but some choose to wait until they are sexually active.
Most will benefit from self-dilation using a small tube called a dilator, which is pressed against the skin where the vagina should be for 15 to 20 minutes daily. This method works best for those with a dimple in the area and is easier after a bath when the skin is softer.
If dilation therapy does not work then surgery is the next option.
Skin Graft Method: A thin piece of skin is taken from the buttocks and placed over a mold. This skin-mold is then inserted into a new space created between the rectum and urethra. Patients typically use a vaginal dilator for three months, removing it for voiding, bowel movements, showering, and sex. After three months, the dilator is worn mostly at night for about six months.
Peritoneal Vaginoplasty: Small incisions are made in the abdomen and the peritoneum is pulled down to the vaginal opening. Dilation is also necessary after this procedure. Another approach involves placing a tensioning device to slowly stretched the vagina over the course of a few days in the hospital.
Bowel Vaginoplasty: This more complex method involves removing a small segment of the lower colon and relocating it to the pelvis into a new space between the rectum and urethra. Often done laparoscopically, this surgery does not require a long-term mold, but the hospital stay is longer as bowel function returns. Usually, only one operation is needed, and stenosis is rare.
Choose UCI Pelvic Health Center
If you or a loved one is experiencing symptoms of vaginal agenesis, the UCI Pelvic Health Center is here to help. Our expert team provides comprehensive diagnosis and tailored treatment options, including non-surgical and surgical methods, to ensure the best possible outcomes.