Doctors at Mayo Clinic treat vaginal agenesis, a condition that develops before birth. When the muscular canal (vagina) to your uterus fails to develop fully, other problems also may appear. For example, you may have a small uterus, or none at all.

Your treatment team can include doctors especially trained to treat children and adolescents (pediatricians), female reproductive systems (gynecologists), urinary problems (urogynecologists) and intestinal problems (colorectal surgeons). Your 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.

Some women with vaginal agenesis have a normal uterus and can bear children. Most women with the disorder can't get pregnant, but many have healthy ovaries. It's possible to have babies by in vitro fertilization if your ovaries produce eggs that can be implanted in 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 of female organs.
  • 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 No. 1 for gynecology in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked high performing for gynecology by U.S. News & World Report.

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.

Doctors trained in gynecology, urogynecology and colorectal surgery care for women who have vaginal agenesis at Mayo Clinic in Arizona. These specialists offer the Vecchietti procedure, which isn't available at other Mayo Clinic locations.

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.

Doctors trained in gynecology, urogynecology and colorectal surgery care for women who have vaginal agenesis at Mayo Clinic in Florida.

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.

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

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.

Doctors usually don't diagnose vaginal agenesis until puberty. Typically, a girl between 15 and 18 years of age consults a pediatrician or gynecologist when her period doesn't start. The condition also may be discovered in infancy or childhood while investigating a kidney or skeletal problem or the absence of an anal opening.

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

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.

You may first learn about your disorder in puberty, when your menstrual periods don't start even after you've developed breasts and have underarm and pubic hair. It's also possible that you or your parents learned about it when you were a baby because you had no anal opening. Your vaginal agenesis may have been discovered when you were a little girl during an examination for a kidney problem.

Depending on your age, your Mayo Clinic pediatrician or gynecologist will diagnose your condition based on a physical examination. After your exam, your doctor may order blood and imaging studies to help determine your treatment choices.

  • Ultrasound. The ultrasound image will show 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 at MayoClinic.com.

You may be treated for vaginal agenesis in your late teens or early 20s, or 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. Whatever your stage, a team of doctors in Minnesota trained in pediatrics, gynecology, urogynecology and colon and rectal surgery are ready to care for you.

You may find it helpful to talk with a counselor about your condition. Psychologists at Mayo Clinic can answer your questions and help you deal with any problems you may have managing the implications of your 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 dilation.

Self-dilation

You may be able to create a vagina without surgery using self-dilation. You'll press a small, round rod (dilator) against your skin or inside your existing vagina for 15 or 20 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'll switch to larger dilators. It may take a few months to get the result you want.

Surgery

If dilation doesn't work, you and your team may decide that surgery is the best option. The most appropriate surgery (vaginoplasty) depends on your age and condition. Two types of surgery may be used to create a functional vagina. These treatments are usually delayed until you have the maturity to handle follow-up dilation.

  • Skin graft (McIndoe procedure). The most common surgery, skin graft 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 for one week. After that, you'll use a vaginal dilator, similar to a firm tampon, which you'll 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. If you receive care at Mayo Clinic in Arizona, your treatment team may suggest the laparoscopic Vecchietti procedure to create your vaginal opening. Your doctor will place an olive-shaped device at your vaginal opening and with laparoscopic guidance connect it to a traction device on your lower abdomen. The traction device is tightened 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. Your surgeon may recommend a bowel vaginoplasty. In that procedure, your doctor diverts a portion of your colon to an opening in your genital area, creating a new vagina. Your remaining colon is then reconnected. You won't have to use a vaginal dilator every day after this surgery.

Mayo Clinic researchers seek innovative treatments for many types of gynecologic problems.

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.

Nov. 20, 2012