Is congenital absence of vagina related to infection?

Is congenital absence of vagina related to infection? Congenital absence of vagina is caused by internal or external factors that hinder the development of the embryo during development, or it may be caused by abnormal development of the paramesonephric duct due to gene mutation (there may be a family history). With normal female chromosome karyotype, normal systemic growth and female secondary sexual characteristics, normal vulva, vaginal absence, uterine development (only two horns remain), small fallopian tubes, and normal ovarian development and function. Patients with Rokitansky-Kustner-Hauser syndrome, which is often characterized, are the most common. Patients with testicular feminization (androgen insensitivity syndrome) are relatively rare. A very small number of people have true hermaphroditism or gonadal dysgenesis. Congenital absence of vagina is not contagious and is not infectious.

Most patients with congenital absence of vagina only have completely closed vaginal vestibule mucosa at the normal vaginal opening, with no trace of vagina. Some patients also have shallow depressions in the vaginal vestibule, and some have blind vaginas shorter than 3 cm. It is often accompanied by no deformity, and only slightly thickened strips of tissue are seen in the normal uterine position, located in the middle of the broad ligament. About 1/10 patients may have partial uterine body development and functional endometrium. After puberty, due to menstrual blood retention, periodic abdominal pain occurs, no menstruation, or it is not discovered until after marriage when they seek medical examination due to sexual intercourse difficulties.

The principle of treatment for congenital absence of vagina is to reconstruct the vagina. There are various methods for artificial vaginal formation, including non-surgical treatment, which is to gradually push the closed vestibule mucosa in the normal vaginal position along the vaginal axis to the head side 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 involves separating the urethra, bladder and rectum to form an artificial cavity, and using different methods to find an appropriate cavity wound covering material to reconstruct the vagina. In previous years, the most common method used was the patient's own medium-thickness free skin graft, but 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 work and life. Moreover, the differences in the characteristics of skin and mucosal tissues are too great, and they do not meet physiological requirements, which is their biggest disadvantage.

Vaginoplasty using labia skin flaps destroys the normal vulva shape 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 mainly be based on the patient's vulvar local anatomy and other specific clinical conditions.