B-ultrasound diagnosis of congenital absence of vagina

Congenital absence of vagina is caused by the failure of bilateral paramesonephric ducts to extend to the caudal end to form a tube after merging. Most cases are accompanied by the absence of uterus or only rudimentary uterus, but a very small number of cases may have a normally developed uterus. Half of cases are accompanied by urinary tract malformations. Generally, they have normal ovarian function and normal development of secondary sexual characteristics. Traditional Chinese medicine calls congenital absence of vagina "lines" or "stone women", which are mostly caused by insufficient congenital endowment and kidney deficiency.

[Diagnostic points]

1. Primary amenorrhea.

2. Difficulties in sexual life.

3. Cyclic abdominal pain: Those with a uterus or residual uterus and ovaries may experience cyclical abdominal pain, with the same symptoms as hymen occlusion.

4. General examination: Secondary sexual characteristics are normal, often accompanied by malformations of the urinary and skeletal systems.

5. Gynecological examination: normal vulva development, no vagina or short vagina, anal examination may show no cervix and uterus, or only a hypoplastic uterus. 6. Ovarian function test: normal ovarian sex hormones.

7. Chromosome examination: 46XX.

8. Ultrasound examination: no vagina, most of them have no uterus, and both ovaries are present.

9. Laparoscopy: can help diagnose the presence of a uterus. The ovaries are usually normal.

[Differential diagnosis]

1. Testicular feminization with short vagina and no uterus: abnormal chromosome examination.

2. Vaginal septum: It is often accompanied by a well-developed uterus, and a small hole is often seen on the left side of the septum.

[Traditional Chinese Medicine Treatment]

Syndrome differentiation and treatment:

(1) Deficiency of liver and kidney: [Symptoms] Menstruation has not stopped for more than a year, and there is no leucorrhea; dizziness, tinnitus, soreness of waist and knees, fatigue, normal bowel movements, pale tongue, white fur, deep, thready and weak pulse [Treatment] Nourish the liver and kidney and regulate Chong and Ren.

(2) Qi stagnation and blood stasis: [Symptoms] Amenorrhea, or abdominal distension and pain after vaginoplasty, or stabbing pain that refuses to be pressed; chest and flank distension, purple tongue, or petechiae, deep, stringy or astringent pulse. [Treatment] Regulate Qi and activate blood circulation, regulate menstruation and relieve pain.