Can congenital absence of vagina be cured by taking medicine?

The principle of treating congenital absence of vagina is to reconstruct the vagina. There are various methods of artificial vaginal formation, including non-surgical treatment, which is to use the means of top pressure to gradually push the closed vestibule mucosa in the normal vaginal position toward the head end along the vaginal axis to form an artificial cavity. This method requires a long treatment time and the artificial vagina formed is short. If the tissue elasticity is poor, it is difficult to succeed. It is now basically abandoned and rarely used. Surgical treatment mainly separates the urethra, bladder and rectum to form an artificial cavity, and uses different methods to find an appropriate cavity wound covering to reconstruct the vagina.

In the past, the most common method was to use the patient's own free medium-thickness skin graft. However, after surgery, a hard vaginal mold needs to be used for a long time to expand the artificial vagina to prevent the artificial cavity covered by the grafted skin from contracting, which increases the patient's pain and brings great inconvenience to the worker and life. Moreover, the characteristics of skin and mucosal tissues are too different, and they do not meet physiological requirements, which is their biggest disadvantage. Vaginoplasty using labia skin flaps destroys the normal vulva morphology and is often rejected by patients. Reconstruction using sigmoid colon or ileum segments increases the complexity of the operation. Covering with amniotic membrane or pelvic peritoneum also has its own disadvantages. Therefore, although there are many methods, there is still no very ideal shaping surgery. The choice should be mainly based on the local anatomy of the patient's vulva and other specific clinical conditions. In recent years, with the progress of microsurgery, vascularized myocutaneous flaps have been used to cover the cavity, opening up a new way for this operation. Its advantages and disadvantages need to be promoted before a conclusion can be drawn.

When the paramesonephric duct is severely dysplastic, there is often incomplete renal rotation, low migration of the kidney, or migration to the pelvic cavity, forming pelvic kidney, horseshoe kidney, transboundary renal ectopia (two kidneys are located on the same side of the body), renal agenesis, renal insufficiency and other urinary tract malformations. Literature reports that in RKH syndrome, renal malformations account for more than 30%. Therefore, when vaginoplasty is performed on cases of congenital absence of vagina, intravenous pyelography should be performed before the operation to be alert to the presence of the above malformations and avoid surgical injuries. In addition, patients with this disease also have skeletal deformities, accounting for about 10%, including spina bifida, sacral occult fracture, vertebral fusion and spinal non-segmentation.