Congenital absence of vagina

Introduction Congenital absence of vagina to normal female chromosome karyotype, systemic growth and secondary sexual development of women, normal vulva, vaginal loss, uterine development (only double angle residual), small fallopian tube, ovarian development and normal function are often characterized Patients with Rokitansky-Kustner-Hauser syndrome are the most common. Patients with testicular feminization (androgen insensitivity syndrome) are less common. Very few are true hermaphroditism or gonadal dysplasia. Most congenital vaginal patients have only a completely occluded vaginal vestibular mucosa in the normal vaginal opening, no vaginal marks, and some patients have shallow depressions in the vestibule of the vagina, and some have a blind end vagina shorter than 3 cm. Often accompanied by no deformity.

Cause

Congenital vaginal etiology mainly has the following aspects:

(1) chromosomal abnormalities;

(2) androgen insensitivity syndrome;

(3) The mother uses androgen, anticancer drugs, reaction stop, etc. in the early pregnancy;

(4) There is no obvious abnormal performance before puberty, which is often neglected. After puberty with abnormal uterine development, it is manifested as primary amenorrhea, post-marital sexual intercourse disorder, small uterus and deformity. Infected with certain viruses or toxoplasma during the first trimester.

an examination

Related inspection

Gynecological gynecological routine examination gynecological ultrasound examination

Diagnose based on

1. Pre-puberty is often overlooked. If examined carefully, with or without a hymen, there is a shallow depression or a short shallow vagina at the mouth of the hymen.

2. With or without uterine dysplasia. If the uterus is abnormal, and the uterus is characterized by primary amenorrhea, the uterus is young or deformed. If the uterus is normal, the primary amenorrhea is accompanied by periodic abdominal pain, intrauterine hemorrhage, and uterus enlargement.

3. Sexual life disorders.

4. With ovarian hypoplasia, secondary sexual development is incomplete, short stature, neck, elbow valgus and other deformities.

Differential diagnosis

Congenital non-vaginal differential diagnosis:

1. Hymen atresia: The shape and size of the hymen hole and the thickness of the membrane vary from person to person. Generally, the hymen hole is located in the center, which is in the shape of a half moon. Occasionally, there is a septum. The hymen hole is divided into two halves, which are called the septum or the two-hole hymen. There is also a membrane in the form of a sieve covering the vaginal opening, which is called a sieve-like hymen. If the hymen pleats are over-developed, it is a non-porous hymen, which is a hymen atresia, which is more common in female genital dysplasia. Diagnosis can be based on symptoms and signs.

2, primary amenorrhea: refers to women who have reached the age of 18 or the second sexual characteristics have matured for more than 2 years and still have no menstrual cramps. Found in uterine hypoplasia or lack of congenital genital dysplasia, congenital ovarian hypoplasia or absence, primary pituitary gonadotropin hypofunction and congenital adrenal hyperplasia and other diseases, a small number should be excluded from the lower genital tract atresia False amenorrhea.

Girls who are 18 years old and have not had menstruation should go to the hospital for examination. Determine the cause of amenorrhea as much as possible based on medical history, comprehensive physical examination, and necessary auxiliary examinations. Further treatment according to different causes, such as congenital uterine hypoplasia can be oral small doses of estrogen to promote development, for congenital malformations (such as no vagina, vulvar deformity and lower genital atresia, etc.) can be surgical orthopedic.

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