Vaginal Agenesis

Definition - What does Vaginal Agenesis mean?

Vaginal agenesis is a rare birth defect in which a girl is born without a vagina. The abnormality usually occurs in association with other anomalies such as incomplete development or complete absence of the uterus. Vaginal agenesis affects 1 out of every 5,000 girls. The absence of vagina makes it impossible for a woman to have sex and get pregnant.

The condition is also known as mullerian aplasia or Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome.

FertilitySmarts explains Vaginal Agenesis

An incomplete development of the baby’s reproductive system before birth gives rise to vaginal agenesis. Affected girls may be diagnosed at birth, or may otherwise not be detected until puberty as is indicated by the absence of menstrual periods. These girls are unable to have intercourse and get pregnant.

Since most affected girls have a MRKH syndrome, they also lack a uterus and kidney/s or when kidneys are present, they are located at an abnormal position. Affected girls often have difficulty urinating and are prone to repeated urinary tract infections. Moreover, hearing loss and a spinal deformity are seen.

Without ever having had menstrual periods, affected females seldom proceed to infertility evaluation. However, since ovaries are present and functioning normally, reproduction may be rarely possible with assisted techniques by having the eggs harvested, fertilized, and implanted in a surrogate.

The treatment of the vaginal deformity can be surgical or non-surgical. The opinion on when these girls should be treated differs among pediatricians. However, most doctors suggest that these girls not be treated before their teens. The non-surgical treatment includes self-dilation as part of the initial management when the girl is in her teens. This helps create a vagina. A vaginal dilator is a small round tube resembling a tampon, which is pressed against the vaginal dimple where the vagina should have been. This is done on a regular basis to stretch the vaginal canal to an adequate length.

In more advanced cases, a reconstructive surgery called a vaginoplasty is used to correct the vaginal defect. It carries more risks as compared to self-dilation yet leads to a near-normal sexual life with high satisfaction rates.

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