Reconstructive surgical management of cryptomenorrhoea because of complete vaginal agenesis
Krishna Dahiya, Ranjita Bains
DOI: 10.4236/ojog.2011.14048   PDF    HTML     5,987 Downloads   9,429 Views   Citations


Background: The Vagina is a composite structure formed partly from the mullerian duct and partly from urogential sinus. Most of the patients with mullerian agenesis have small rudimentary uterus without any endometrial cavity, 7% - 8% may have functioning uterus. Case: A 15 years old girl admitted with primary amenorrhea, cyclical abdominal pain, hematometra and complete vaginal agenesis. Surgical correction is the mainstay of treatment in patients with functioning uterus and absent vagina. Vaginoplasty was done to reconstruct a neovagina using amnion graft and establish uterovaginal continuity. In this case we have used only perineal approach to dissect the neovagina and identify the cervix with formation of a patent drainage tract and adequate vaginal length of 9 cm. Conclusion: In rare cases of obstructed functioning uterus by complete vaginal agenesis, vaginoplasty effectively restores anatomy and function by an overall minimal operative morbidity. Human amnion provides excellent results in neovaginal reconstruction.

Share and Cite:

Dahiya, K. and Bains, R. (2011) Reconstructive surgical management of cryptomenorrhoea because of complete vaginal agenesis. Open Journal of Obstetrics and Gynecology, 1, 243-245. doi: 10.4236/ojog.2011.14048.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Saxena, A.K. and Herman, M.I. (2009) Vaginal Atresia. Webpage. Cited June 02, 2009.
[2] Saraf, S. and Saraf, P. (2007) McIndoe vaginoplasty: Revisited. International Journal of Gynecology and Obstetrics, 6, Online Journal.
[3] Gupta, N.P. and Ansari, M.S. (2002) Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome—A review. Indian Journal of Urology, 18, 111-116.
[4] ACOG Committee Opinion (2002) Nonsurgical diagnosis and management of vaginal agenesis. International Journal of Gynecology and Obstetrics, 79, 167-170. doi:10.1016/S0020-7292(02)00326-0
[5] Jones, H.W. JR. and Scott, W.M. (1958) Hermaphroditism, genital anomalies, and related endocrine disorders. 2nd Edition, Baltimore: Williams & Wilkins Co., 327.
[6] Jones, H.W. Jr. and Wheeless, C.R. (1969) Salvage of the reproductive potential of women with anomalous development of the muellerian ducts. American Journal of Obstetrics and Gynecology, 104, 348-352.
[7] Seccia, A., Salgarello, M., Sturla, M., Loreti, A., Latorre, S. and Farallo, E. (2002) Neovaginal reconstruction with the modified McIndoe technique: A review of 32 cases. Annals of Plastic Surgery, 49, 379-384. doi:10.1097/00000637-200210000-00008
[8] McIndoe, A. (1950) The treatment of congenital absence and obliterative conditions of the vagina. British Journal of Plastic Surgery, 2, 254-267.
[9] Yu, K.J., Lin, Y.S., Chao, K.C., Chang, S.P., Lin, L.Y. and Bell, W. (2004) A detachable porous vaginal mould facilitates reconstruction of a modified mcIndoe neovagina. Fertility and Sterility, 81, 435-439. doi:10.1016/j.fertnstert.2003.06.032
[10] Chohan, A., Burr, F., Mansoor, H. and Falak, T. (2006) Amnion graft in vaginoplasty—An experience at 3 teaching hospitals of Lahore. Biomedica, 22, 21-24.
[11] Fotopoulou, C., Sehouli, J., Gehrmann, N., Schoenborn, I. and Lichtenegger, W. (2009) Functional and anatomical results of amnion vaginoplasty in young women with Mayer-Rokitansky-Kuster-Hauser syndrome. Fertility and Sterility, (Epub ahead of print).
[12] Fedele, L., Bianchi, S., Zanconato, G. and Raffaelli, R. (2000) Laparoscopic creation of neovagina in patients with rokitansky syndrome: Analysis of 52 cases. Fertility and Sterility, 74, 384-389. doi:10.1016/S0015-0282(00)00620-8
[13] Cai, B., Zhang, J.R., Xi, X.W., Yan, Q. and Wan, X.P. (2007) Laparoscopically assisted sigmoid colon vaginoplasty in women with Mayor-Rokitansky-Kuster-Hauser syndrome: Feasibility and shortterm results. British Journal of Obstetrics and Gynaecology, 114, 1486-1492. doi:10.1111/j.1471-0528.2007.01514.x
[14] Rana, A., Gurung, G., Begum, S.H., Adhikari, S. and Neupane, B.B. (2007) Hysterectomy for hematometra in a 15-year-old mentally handicapped girl with congenital cervicovaginal agenesis and concomitant ovarian adenoma. Journal of Obstetrics and Gynecology, 34, 105-107. doi:10.1111/j.1447-0756.2007.00726.x
[15] Roszaman, R. and Ghazali, I. (2006) Vaginal and cervical agenesis—Hysterectomy in a young girl. Internal Medicine Journal, 5.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.