How to treat congenital absence of vagina

Most patients with congenital absence of vagina have normal external genitalia. However, due to some abnormal differentiation during embryonic development, only a very shallow pit evolved from the urogenital sinus during embryonic development or a short and shallow lower vagina about 2 cm deep can be seen at the vaginal opening, and sometimes the hymen can also be seen. These women cannot have sex after marriage.

Usually, they also have congenital absence of uterus, so they have no menstruation. Of course, they cannot have children. Even with surgical correction, the fertility problem cannot be solved. If the patient has a normal uterus and the ovaries and endometrium function normally, the patient can seek medical attention after puberty due to periodic abdominal pain caused by menstrual blood retention and receive timely treatment. If there is no uterus or the uterus is very immature, the treatment of congenital absence of vagina is best performed before or shortly after marriage.

(I) Non-surgical compression methods require patients to have a certain degree of perseverance, be able to endure certain pain, and make persistent efforts to have hope of success. Patients can be taught to operate on their own. Ask the patient to lie on his back, and use a smooth round wooden stick or solid glass stick with a diameter of 1-2 cm to apply pressure backward and upward along the vaginal axis at the depression equivalent to the hymen. Do this several times a day, for about half an hour each time. Since the tissue inside the patient's labia is generally loose, the depression can be as deep as 7-8 cm and as large as 3 cm in diameter after 3-4 months of treatment. Basically, it can solve the problem of sexual life satisfactorily.

(II) Vaginoplasty: Make a transverse incision at the location corresponding to the external opening of the vagina, and bluntly separate the tissues between the urethra, bladder and rectum to form a gap of about 10 cm deep and 3-4 cm in diameter. Then insert the vaginal model covered with amniotic membrane or skin into the formed artificial vagina. After one week, replace the vaginal model, which is generally made of glass, plastic or wood and is 9-11 cm long and 3-35 cm in diameter. It usually needs to be placed for one year. After half a year, start to take it out for 1-2 hours every day, and then gradually extend the removal time. If the operation is performed after marriage, sexual life can be started when the vaginal epithelium grows well and the tissue is soft. At this time, the placement time at night can be appropriately shortened. Once sexual life is stopped for a long time after the operation, the vaginal model still needs to be used to avoid adhesion and vaginal stenosis.