Congenital vaginal atresia: about an uncommon case

Abstract

Congenital vaginal atresia is a rare congenital abnormality of the female reproductive tract due to a failure of canalisation in the urogenital sinus. We report the uncommon case of a 14-year-old girl with a primary amenorrhea associated to a cyclical pelvic pain, in whom examination objectified a vaginal cup that replaced the introitus. Ultrasound examination and magnetic resonance imaging (MRI) revealed atresia of the lower third of the vagina. The diagnosis of partial vaginal aplasia on functional uterus was retained, the patient had a perineal vaginoplasty. The evolution was satisfactory with regular cycles and improvement of pelvic pain. The decline is three years. Congenital vaginal atresia is a rare malformation classically and clinically pictured as a primary amenorrhea with chronic cyclic pelvic pain. Diagnosis is based on clinical examination and imaging. The MRI is designed to assess the importance of atresia and guide surgical management while the surgical technique aims to restore the integrity of the utero-vaginal tract and to increase the possibility of pregnancy for these patients.

Efficacy and safety of laparoscopic vaginoplasty using the peritoneal flap and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

“…Complete vaginal atresia is commonly concurrent with cervical dysplasia or cervical atresia ( 3 , 7 ). Patients with complete vaginal atresia always suffer from abdominal pain, fallopian tube dilation, cyst formation, and pelvic endometriosis due to the hematocele in the uterine or cervical duct and the reflux of menstrual blood into the pelvic cavity ( 5 , 17 ). Currently, the main treatment method for patients with complete vaginal atresia is surgery.…”

“…Congenital vaginal atresia can obstruct menstrual blood flow and can also lead to a series of clinical problems, such as amenorrhea, abdominal pain, pelvic mass, and endometriosis, which require timely surgical dissociation to relieve the obstruction (3,4). Complete vaginal atresia is usually associated with cervical dysplasia or cervical atresia (5)(6)(7). Currently, the main surgical method for patients with complete vaginal atresia is vaginoplasty with or without sparing the uterus (8,9).…”

Efficacy and safety of laparoscopic vaginoplasty with peritoneal flaps and cervicoplasty in patients with congenital cervical and complete vaginal atresia: a pilot study

“…Complete vaginal atresia is commonly accompanied by cervical dysplasia or cervical atresia ( 1 , 13 ). Patients with complete vaginal atresia consistently experience abdominal pain, fallopian tube dilation, cyst formation, and pelvic endometriosis due to hematocele in the uterine or cervical duct and the reflux of menstrual blood into the pelvic cavity ( 3 , 14 ). Unfortunately, there are still no non- or less-invasive techniques that can be applied for patients with congenital cervical and complete vaginal atresia.…”

“…Congenital vaginal atresia can obstruct menstrual blood flow and may also lead to a series of clinical problems, such as amenorrhea, abdominal pain, pelvic mass, and endometriosis, which require timely surgical dissociation to relieve the obstruction ( 2 ). Complete vaginal atresia is usually associated with cervical dysplasia or cervical atresia ( 1 , 3 , 4 ). Currently, the main surgical method for patients with complete vaginal atresia is vaginoplasty with or without sparing of the uterus ( 5 , 6 ).…”

Isolated distal vaginal hypoplasia and megalourethra in a regularly menstruating female treated by pull through procedure

“…Clinically, it presents with primary amenorrhea, cryptomenorrhea, apareunia, and cyclic chronic pelvic pain. 1 Lower vaginal hypoplasia is a rare subtype of congenital lower vaginal atresia. There is no single publication in the English literature on isolated congenital vaginal hypoplasia.…”