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Vaginal Agenesis

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Introduction

Of all the congenital anomalies a woman can inherit, vaginal agenesis is just one. It can be one of the symptoms among a wider range of reproductive complications a woman may have to face.  It is said to affect around 1 out of every 5000 newborns. Now, you might be anxious that it’s going to affect your daughter’s future marital life. Set the worries aside because it’s curable so much so that the girl herself will forget that she was diagnosed with Vaginal Agenesis at any stage of her life.

Vaginal Agenesis is a situation where the vagina gets misconfigured during embryonic development. It either does not develop at all marked by a complete absence of vagina or is partially developed where the lower part of the vagina may be missing. Along with this, other reproductive organs can also be underdeveloped. However, the girl will have normal external genitalia and will undergo the natural cycle of puberty except having menstruation.

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What are the Causes of Vaginal Agenesis?

Medical science is yet to figure out the exact reasons behind Vaginal Agenesis. But, certain disorders are definitive in women diagnosed with Vaginal Agenesis and thus provide a clue for its occurrence.

  • Mayer-Rokitansky-Kuster-Hauser Syndrome: Mullerian Ducts which form the fallopian tubes, uterus, cervix and a certain portion of vagina fail to develop properly during the gestation period.
  • Bardet-Biedl Syndrome: A genetic disorder that affects the reproductive and urinary system. The capacity of ovaries to produce enough eggs is reduced. Fallopian tubes and uterus can also be underdeveloped. This can also be associated with kidney issues.
  • ● Infants who often have eyes covered with skin or fingers fused with each other carry the chances of being diagnosed with Vaginal Agenesis.

What are the Symptoms of Vaginal Agenesis?

Most of the disorders associated with reproductive tracts have characteristic symptoms. Those of Vaginal Agenesis include:

  • Sepsis in infants: It is a condition in which the body starts harming its own tissues while trying to counter infections. Sepsis is identified with increased breathing rate and heart rate.
  • ● Swelling in the abdomen or a sensation of heaviness in the lower abdominal area in the case when the uterus is not connected to the vaginal canal.
  • ● Respiratory distress in infants
  • ● A small oval structure at the place of the vaginal opening
  • ● Among adolescents, symptoms of Vaginal Agenesis include missing periods despite arriving at puberty or even if menstruation commences, the blood gets filled in the upper vagina
  • ● Difficulty in having sexual intercourse.

How is Vaginal Agenesis Diagnosed?

Vaginal Agenesis can be detected in the infant right after the birth by external inspection of genitalia. Since it is also recognisable with the presence of other disorders such as improper functioning of kidneys, the doctor will thoroughly look whether the vagina is present or not. If not detected right after birth, Vaginal Agenesis can be confirmed in adolescence in case of amenorrhea. Ultrasound and MRI (Magnetic Resonance Imaging) will be carried out for getting a clear view of all the abnormalities in reproductive organs. The doctor can also ask for the blood tests to confirm Rokitansky-Mayer-Kuster-Hauser Syndrome. An examination of chromosomes can be done to determine genetic causes behind the disorder. This process is also known as Karyotyping.

How is Vaginal Agenesis Treated?

The treatment for Vaginal Agenesis includes both surgical as well as non-surgical methods.

  • ● The non-surgical method includes vaginal dilation. Dilators which are in the shape of tampons are used to create a cavity precisely where the vagina should have existed naturally. These are pressed regularly until satisfactory space is not created.
  • ● Vaginoplasty or artificial construction of the vagina is carried out if non-surgical methods fail to accomplish the task. This is done either by taking out skin from buttocks and making a vagina out of it (skin grafting) or by closing one end of the bowel and by making the lower end of the colon as the vaginal opening.

What is the Results of Vaginal Agenesis Treatment?

Life gets normal after the treatment. You will have a healthy sex life and can have children as well. However, you need to use the dilator for about three months after vaginoplasty. The only drawback of this method is that it brings with it the issue of vaginal tightening.

What are the Risks Associated with Vaginal Agenesis treatments?

Surgeries carry risks along with them. The risks associated with Vaginal Agenesis include the danger of infection, closing of vaginal opening if dilator is not used properly, skin necrosis and bleeding.

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FAQ's

Are Dilators Enough to Treat Vaginal Agenesis?

In most cases, dilators serve the purpose when used regularly and efficiently. It should be used for around 15-20 minutes once or twice a day. Depending upon the space to be created, the dilator can be used for 2 months to 2 years. Size of the instrument is increased as the time progresses to hasten the process. In fact, doctors prefer self-dilation most of the time over surgery.

Can I have a Normal Sex Life After Getting Treatment?

Yes, Of Course, but after 4-6 weeks of the surgery. Even your partner won’t be able to figure out that you have ever undergone any surgery. The only problem you may encounter is with the lubrication since it’s not natural vaginal tissue.

Is it Possible to Get Pregnant Without a Uterus?

It is impossible to get pregnant without a uterus since there’s no way left for the sperm to Fertilise and it gets wasted away along with other vaginal secretions.

Is Vaginal Agenesis Hereditary?

There have been no cases of Vaginal Agenesis being transmitted from parents. It is a congenital disorder, i.e. present right from the birth due to incomplete fetal development.

What Does MRKH Entail?

MRKH stands for Mayer-Rokitansky-Kuster-Hauser Syndrome. It is marked by a lack of completely developed uterus, cervix and one-third of the vagina. However, external genitals are developed, and other signs of puberty are visible too.

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