This case report describes a case of isolated (not associated with other anomalies) lower vaginal hypoplasia complicated by megalourethra (urethral dilatation) due to frequent urethral sexual intercourse in a regularly menstruating (hypomenorrheic) woman. The patient was a 24-year-old woman who underwent transperineal ultrasonography as well as magnetic resonance imaging followed by sequential cystoscopic and vaginoscopic examinations. Finally, a pull-through procedure was used to create a new vagina. The main outcome measure was patent vagina formation. The procedure successfully corrected isolated lower vaginal hypoplasia. The postoperative course was smooth, with the restoration of regular intercourse in the correct location. It was concluded that all gynecologists should have increased awareness of rare female genital anomalies to avoid serious sequelae, particularly in newly married patients.