Ultrasound diagnosis of congenital absence of vagina

Congenital absence of vagina is the result of bilateral hypoplasia of the paramesonephric ducts, so congenital absence of vagina is almost always accompanied by absence of uterus or only traces of uterus, but the ovaries are generally normal. Most patients have not had menstruation since puberty, or have difficulty in sexual intercourse after marriage. So, what is the method of ultrasound diagnosis of congenital absence of vagina?

Examination shows that the vulva and secondary sexual characteristics are normally developed, but there is no vaginal opening or only a shallow depression is seen at the external opening of the vagina. Sometimes a short shallow vaginal blind end of about 2 cm formed by the invagination of the urogenital sinus can be seen. Anal examination and pelvic B-type ultrasound examination show no uterus, and about 15% of cases are combined with urinary tract malformations. Clinically, this disease should be differentiated from complete androgen insensitivity syndrome. The latter has a 46, XY chromosome karyotype, and is different from congenital absence of vagina in that pubic hair and axillary hair are very rare, and blood testosterone is elevated.

Diagnosis is based on clinical symptoms. Examination shows that the vulva and secondary sexual characteristics are normally developed, but there is no vaginal opening or only a shallow depression is seen at the external vaginal opening. Sometimes a short and shallow blind vagina of about 2 cm formed by the invagination of the urogenital sinus can be seen. Anal examination and pelvic B-type ultrasound examination show no uterus, and about 15% of cases have urinary tract malformations.