Description

Agenesis of the vagina (a-JEN-uh-sis) is a rare disorder in which the vagina does not develop, and the womb (uterus) can only be developed partially or not at all. This condition is present before birth and may also be associated with kidney failure or problems in the skeleton.

The condition is also known as agenesis and mullerian, mullerian aplasia or Mayer-Rokitansky-Kuster-Hauser syndrome.

Agenesis Vaginal is often identified at the time of puberty when a woman does not begin to menstruate. The use of a vaginal dilator, a tubular device that can stretch the vagina when used over a period of time, is often effective in the creation of a vagina. In some cases, surgery may be needed. The treatment makes it possible to have vaginal sex.

Symptoms

Agenesis Vaginal often goes unnoticed until the females reach adolescence, but do not have menstruation (amenorrhea). Other signs of puberty, in general, follows the typical development of the woman.

Agenesis Vaginal may have these characteristics:

  • The genital appearance of a typical female.
  • The vagina can be reduced without cervix in the end, or absent, and, marked by a slight indentation where a vaginal opening is normally found.
  • There can be no uterus, or one that is only partially developed. If there is tissue that lines the uterus (endometrium), monthly cramps, or chronic abdominal pain may occur.
  • The ovaries are normally fully developed and functional, but they may be in an unusual location in the abdomen. Sometimes the pair of tubes that eggs travel to get the information from the ovaries to the uterus (fallopian tubes) are absent or do not develop normally.

Agenesis Vaginal may also be associated with other problems, such as:

  • Problems with the development of the kidneys and urinary tract
  • The developmental changes in the bones of the spine, ribs, and wrists
  • Hearing problems
  • Other congenital conditions that also affect the heart, the gastrointestinal tract and limb growth

When to see a doctor

If you have not had a menstrual period by the age of 15 years, consult your health care provider.

Causes

It is not clear what causes agenesis vaginal, but at some point during the first 20 weeks of pregnancy, tubes called ducts müller don't develop properly.

Typically, the bottom of these ducts develop into the uterus and the vagina, and the upper part becomes the fallopian tubes. The underdevelopment of the duct of müller results in the absence or partial closure of the vagina, absent or part of the uterus, or both.

Complications

Agenesis Vaginal may affect their sexual relations, but after the treatment, her vagina will tend to perform well during sexual activity.

Women with a missing or partially developed uterus can't get pregnant. If you have ovaries, however, it is possible to have a baby through in vitro fertilization. The embryo can be implanted into the uterus of another person to carry the pregnancy (gestational carrier). Discuss fertility options with your health care provider.

Diagnosis

Your pediatrician or gynecologist will make the diagnosis of agenesis vaginal based on medical history and a physical examination.

Agenesis Vaginal usually diagnosed during puberty, when your menstrual periods do not start, even after you have developed breasts and I have armpit and pubic hair. Sometimes the agenesis vaginal can be diagnosed at a younger age, during an evaluation for other problems, or when parents or a doctor notice of a baby does not have the vaginal opening.

Your health care provider may recommend tests, including:

  • Blood tests. Blood tests to evaluate your chromosomes and measure their levels of the hormone can confirm the diagnosis and rule out other conditions.
  • Ultrasound. Ultrasound images to show your health care provider if you have a uterus and ovaries and to determine if there are problems with your kidneys.
  • Magnetic resonance imaging (MRI). A magnetic resonance imaging gives your health care provider a detailed picture of your reproductive tract and the kidneys.
  • Other tests. Your doctor may also order other tests to check your hearing, heart and skeleton.

Treatment

The treatment of agenesis vaginal often occurs in the late teens or early 20s, but you can wait until you're older and you feel motivated and ready to participate in the treatment.

You and your healthcare provider can discuss treatment options. Depending on the condition of each one, the options may involve no treatment or creation of a vagina by self-dilation or surgery.

Self-dilation

Self-dilation is generally recommended as the first option. Self-dilatation may allow you to create a vagina without surgery. The goal is to lengthen the vagina to a comfortable size to have sex.

During the self-dilation, press a small round rod (dilators) — similar to that of a company of buffer against your skin in your vaginal opening or existing in the interior of your vagina for 10 to 30 minutes 1 to 3 times a day. As the weeks go by, you can change to larger dilators. It may take a couple of months to get the result you want.

Discuss the process of self-dilation with your health care provider so that you know what to do and talk about dilator options to find what works best for you. The use of self-dilation at the intervals recommended by your health care provider or have many relationships that more time was needed to maintain the length of your vagina.

Some patients report problems with urination and vaginal bleeding and pain, especially in the beginning. Artificial lubrication and try a different type of dilator can be useful. Your skin stretches more easily after a hot bath, so that may be a good time for expansion.

Vaginal dilation through frequent sexual intercourse is an option for self-expansion of women who have been willing partners. If you'd like to give this method a test, talk to your doctor about the best way to proceed.

Surgery

If the self-dilation does not work, surgery to create a vagina functional (srs) can be an option. Types of surgery vaginoplasty include:

  • The use of a graft tejido.Su surgeon may choose from a variety of grafts using your own tissue to create a vagina. Possible sources include the skin of the outer part of the thigh, the buttocks or the lower abdomen. The surgeon makes an incision to create the opening of the vagina, place the tissue graft over a mould to create the vagina, and placed in the newly formed channel. The mold is held in place around a week. Usually, after the surgery to keep the mold or a vaginal dilator in place, but can be removed when using the bathroom or having sex. After the initial time recommended by your surgeon, you'll need to use the dilator is only in the evening. Sex with artificial lubrication and occasional dilation, helping to maintain a functional of the vagina.
  • The insertion of a medical traction device.The surgeon places an olive-shaped device (Vecchietti procedure) or a balloon device (the balloon vaginoplasty) in your vaginal opening. The use of a thin, lighted viewing instrument (laparoscope) as a guide, the surgeon connects the device to another device of traction in the lower part of the abdomen, or through your belly button. You squeeze the traction device of each day, slowly pulling the device into the interior to create a vaginal canal for about a week. After the device is removed, you will have to use a mold of different sizes around three months. After three months, you can use more self-dilation or regular sex to maintain a functional of the vagina. The sex is likely to require lubrication artificial.
  • The use of a portion of the colon (bowel vaginoplasty). In a bowel vaginoplasty, the surgeon moves a part of your colon to an opening in the genital area, the creation of a new vagina. The surgeon then reconnects the rest of your colon. You don't have to use a vaginal dilator each day after this surgery, and it is less likely that the need for artificial lubrication for sexual intercourse.

The use of a tissue graft. Your surgeon may choose from a variety of grafts using your own tissue to create a vagina. Possible sources include the skin of the outer part of the thigh, the buttocks or the lower abdomen.

The surgeon makes an incision to create the opening of the vagina, place the tissue graft over a mould to create the vagina, and placed in the newly formed channel. The mold is held in place around a week.

Usually, after the surgery to keep the mold or a vaginal dilator in place, but can be removed when using the bathroom or having sex. After the initial time recommended by your surgeon, you'll need to use the dilator is only in the evening. Sex with artificial lubrication and occasional dilation, helping to maintain a functional of the vagina.

The insertion of a medical traction device. The surgeon places an olive-shaped device (Vecchietti procedure) or a balloon device (the balloon vaginoplasty) in your vaginal opening. The use of a thin, lighted viewing instrument (laparoscope) as a guide, the surgeon connects the device to another device of traction in the lower part of the abdomen, or through your belly button.

You squeeze the traction device of each day, slowly pulling the device into the interior to create a vaginal canal for about a week. After the device is removed, you will have to use a mold of different sizes around three months. After three months, you can use more self-dilation or regular sex to maintain a functional of the vagina. The sex is likely to require lubrication artificial.

After the surgery, the use of a mould, the dilation or the frequency of sexual relations is necessary to keep the vagina functional. Health care providers usually delay surgical treatment until you are ready and able to handle the self-dilation. Without expansion, the newly created vaginal canal can quickly narrow and reduce, therefore, to be emotionally mature and ready to comply with the after-care is critically important.

Talk with your health care provider about the best surgical option to suit your needs, and the risks and requires careful after the surgery.

Coping and support

Learning has agenesis vaginal can be difficult. That is why your health care provider will recommend you to a psychologist or a social worker to be part of your treatment team. These mental health providers can answer your questions and help you deal with some of the most difficult aspects of having agenesis vaginal, such as the possible infertility.

You may prefer to connect with a support group of women who are going through the same thing. You may be able to find a support group online, or you can ask your health care provider if he or she knows of a group.

Preparing for your appointment

You will probably start by discussing your symptoms with your primary care doctor or your child's pediatrician. He or she is likely to see a doctor that specializes in women's health (ob).

What you can do

To prepare for your appointment:

  • Make a list of the signs and symptoms you have, including those that may seem unrelated to the reason for your appointment.
  • Make a list of all the medications you are taking, including prescription and non-prescription medicines, vitamins, herbal preparations and supplements, and note the dose.
  • Ask a family member or friend to come with you, if you feel comfortable with that. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Prepare questions to ask your health care provider, so that you do not forget to cover something that is important to you.

Some basic questions to ask include:

  • What is the likely cause of my condition?
  • Do I need any tests?
  • Is my condition temporary or long-term?
  • What treatments are available and what do you recommend?
  • Are there any restrictions that I need to follow?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

What to expect from your doctor

Questions to your health care provider can do include:

  • What are vaginal symptoms you are experiencing?
  • How long have you experienced these symptoms?
  • Has had a menstrual period?
  • How much distress do your symptoms do they cause?
  • Are you sexually active?
  • Does the condition limit your sexual activity?
Symptoms and treatment of agenesis Vaginal