Absent vagina a description of cases with varied ages, presentations and reconstructions

Abstract

The aim is to describe cases of vaginal agenesis of varied ages presentations and managements and report the outcome of interventions regarding restoration of continuity of reproductive tract and normal sexual activity.  A prospective descriptive case series study. Five female patients with vaginal agenesis were recruited from November 2005 to November 2016. Three were adolescents and had a functioning uterus. Three patients underwent vaginoplasty using McIndoe method, one had vagino-vaginal anastomosis, and the other had hysterectomy to remove source of menstruation.  Age ranged from 12 to 24 years. The outcome of vaginoplasties to the 2 young females and to one of the adolescent girls was adequate vagina, whereas the other 2 adolescent girls had failed redo vaginoplasty and ended with a patent narrowed vagina in one and a closed vagina in the other which required a hysterectomy. On Follow up (range 5 - 42 months) 2 of the adolescent’s girls had regular menstruation with no pain and pelvic collection, while the third one had amenorrhoea following a hysterectomy. The 3 patients who had successful vaginoplasty got married and enjoyed satisfactory intercourse. Patients with absent vagina presents at variable ages depending on whether a functioning uterus is present or not. The success of vaginoplasty is less when it has to be done in adolescence than when it is done in adulthood when patient is grown-up. Best outcomes require accumulative experience, ideally with the aid of doctors of other specialties.