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.
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.
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:
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- 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.
- Laufer MR. Diagnosis and management of congenital anomalies of the vagina. http://www.uptodate.com/home. Accessed Dec. 3, 2013.
- Raziel A, et al. Surrogate in vitro fertilization outcome in typical and atypical forms of Mayer-Rokitansky-Kuster-Hauser syndrome. Human Reproduction. 2012;27:126.
- American College of Obstetricians and Gynecologists Committee on Adolescent Health Care. Committee Opinion No. 562: Müllerian agenesis — Diagnosis, management and treatment. Obstetrics & Gynecology. 2013;121:1134.
- Morcel K, et al. Sexual and functional results after creation of a neovagina in women with Mayer-Rokitansky-Kuster-Hauser syndrome: A comparison of nonsurgical and surgical procedures. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2013;169:317.
- Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed Dec. 4, 2013.
- Baggish MS, et al. Atlas of Pelvic Anatomy and Gynecologic Surgery. 3rd ed. St. Louis, Mo.: Elsevier Saunders; 2011:811.
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