Vaginal agenesis (a-JEN-uh-sis) is a condition that develops before birth, in which the muscular canal (vagina) to your uterus fails to develop fully. When this happens, other problems also may appear. For example, you may have a small uterus or, more commonly, no uterus at all.

For vaginal agenesis, your treatment team can include doctors specially trained to treat children and adolescents (pediatricians), female reproductive systems (gynecologists and urogynecologists) and intestinal problems (colorectal surgeons). Your treatment team works with you to find the most appropriate solution for your disorder.

After treatment, you may be able to have a normal sex life. Most women with the disorder can't get pregnant. If you have healthy ovaries, however, it may be possible to have a baby through in vitro fertilization using a surrogate mother.

  • Experience. Mayo Clinic's experienced pediatricians and gynecologic and colorectal surgeons have worked together for many years treating girls and women who are born with developmental abnormalities.
  • Expertise. Doctors at Mayo Clinic have developed multisystem approaches to treating adolescent girls and women who have congenital problems with their reproductive organs.
  • Team approach. Integrated teams of doctors trained in several specialties work closely together to care for women and girls who have problems related to vaginal agenesis.

Mayo Clinic in Rochester, Minn., ranks #1 for gynecology in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., is ranked among the Best Hospitals for gynecology, and Mayo Clinic in Jacksonville, Fla., is ranked high performing for gynecology by U.S. News & World Report.

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Depending on your age, your Mayo Clinic pediatrician or gynecologist diagnoses your condition based on your medical history and a physical exam. Vaginal agenesis diagnosis can happen at different times in your life, for instance:

  • As a baby, if your parents or doctor discover that you have no vaginal or anal opening
  • As a young girl, during an examination for a suspected kidney problem
  • During puberty, when your menstrual periods don't start even after you've developed breasts and have underarm and pubic hair

To determine your treatment options, your doctor may recommend other testing, including:

  • Blood tests. Your doctor may order blood tests to assess your chromosomes and measure your hormone levels, which can confirm your diagnosis and rule out other conditions.
  • Ultrasound. The ultrasound image shows your doctor whether you have a uterus and ovaries and where your kidneys are located.
  • Magnetic resonance imaging (MRI). An MRI gives your doctor a detailed picture of your reproductive tract and kidneys.

Read more about ultrasound and MRI.

Treatment for vaginal agenesis often occurs in your late teens or early 20s, but you may wait until you're older. If your parents learned about your condition when you were an infant or young girl, you may have already begun treatment.

In addition to working with your treatment team, talking with a counselor about your condition might be helpful. Psychologists at Mayo Clinic can answer your questions and help you deal with the implications of having vaginal agenesis.

Depending on your individual condition, your doctor may recommend one of the following courses of treatment.

Self-dilation

As a first step, your doctor will probably recommend self-dilation. Self-dilation may allow you to create a vagina without surgery. You press a small, round rod (dilator) against your skin or inside your existing vagina for at least 30 minutes a day. Your skin stretches more easily after a warm bath so that's the best time to do it. As the weeks go by, you switch to larger dilators. It may take a few months to get the result you want.

Surgery

If self-dilation doesn't work, surgery to create a functional vagina (vaginoplasty) may be an option. Doctors usually delay surgical treatments until you have the maturity to handle follow-up dilation. Options for vaginoplasty surgery include:

  • Skin graft (McIndoe procedure). In the McIndoe procedure, your surgeon uses skin from your buttocks to create a vagina. Your surgeon makes an incision in the area where you'll have your vagina, inserts the skin graft to create the structure and places a mold in the newly formed canal. The mold remains in place for one week. After that, you use a vaginal dilator, similar to a firm tampon, which you remove when you use the bathroom or have sexual intercourse. After a time, you'll use the dilator only at night. Sexual intercourse and occasional dilation helps you maintain a functional vagina.
  • Vecchietti procedure. In the Vecchietti procedure, your surgeon places an olive-shaped device at your vaginal opening. Using a thin, lighted viewing instrument (laparoscope) as a guide, your surgeon connects the olive-shaped device to a separate traction device on your lower abdomen. You tighten the traction device every day, gradually pulling the olive-shaped device inward to create a vagina over about a week. After your doctor removes the device, you'll need further manual dilation.
  • Bowel vaginoplasty. In a bowel vaginoplasty, your surgeon diverts a portion of your colon to an opening in your genital area, creating a new vagina. Your surgeon then reconnects your remaining colon. You won't have to use a vaginal dilator every day after this surgery.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Arizona, doctors trained in gynecology, urogynecology, and colon and rectal surgery care for women who have vaginal agenesis.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Florida, doctors trained in medical and surgical gynecology, urogynecology and reconstructive surgery, and colon and rectal surgery care for women who have vaginal agenesis.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Minnesota, a team of doctors trained in pediatrics, obstetrics and gynecology, urogynecology, and colon and rectal surgery care for adolescent girls and women who have vaginal agenesis.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic Children's Center, specialists in pediatrics, gynecology, urogynecology, and colon and rectal surgery care for adolescent girls who have vaginal agenesis.

For appointments or more information, call 855-MAYO-KID (855-629-6543) toll-free from 7 a.m. to 6 p.m. Central time, Monday through Friday or use an online appointment form below.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

Please refer to the international appointment section to request appointments via phone.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic researchers seek innovative treatments for many types of gynecologic problems. The Women's Health Research Center at Mayo Clinic focuses on understanding and improving the health of women of all ages.

Read more about research at Mayo Clinic.

Publications

See a list of publications on vaginal agenesis by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.

Apr. 16, 2014