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{{Infobox medical condition (new)
{{SI}}
{{Infobox medical condition
| name            = Vaginal hypoplasia
| name            = Vaginal hypoplasia
| synonyms        = Congenital absence of vagina
| image          = [[File:Agenesia_de_vagina2.png|left|thumb|Illustration of vaginal hypoplasia]]
| image          =  
| caption        = Illustration of vaginal hypoplasia
| caption        =  
| field          = [[Gynecology]]
| pronounce      =
| synonyms        = Congenital absence of the vagina, Müllerian agenesis
| field          = [[Gynecology]], [[medical genetics]]
| symptoms        = Absent or underdeveloped [[vagina]], [[amenorrhea]], possible [[infertility]]
| symptoms        =  
| complications  = [[Infertility]], [[sexual dysfunction]]
| complications  =  
| onset          = Congenital
| onset          =  
| duration        = Lifelong
| duration        =  
| causes          = [[Müllerian duct]] anomalies
| types          =
| risks          = Genetic factors
| causes          =  
| diagnosis      = [[Physical examination]], [[imaging studies]]
| risks          =  
| differential    = [[Androgen insensitivity syndrome]], [[Mayer-Rokitansky-Küster-Hauser syndrome]]
| diagnosis      =  
| treatment      = [[Surgical intervention]], [[vaginal dilators]]
| differential    =  
| prognosis      = Variable, depending on associated conditions
| prevention      =
| frequency      = Rare
| treatment      =  
| medication      =
| prognosis      =  
| frequency      =  
| deaths          =
}}
}}
 
{{Short description|A congenital condition affecting the development of the vagina}}
'''Vaginal hypoplasia''' is the underdevelopment or incomplete development of the [[vagina]]. It is a [[birth defect]] or congenital abnormality of the female [[genitourinary system]].
[[File:Inflatable_vaginal_expander.jpg|left|thumb|An inflatable vaginal expander used in treatment]]
 
[[File:ZSI_200_NS_Vaginal_Expander_in_Vagina.jpg|left|thumb|Vaginal expander in use]]
==Signs and symptoms==
'''Vaginal hypoplasia''' is a congenital condition characterized by the underdevelopment or absence of the [[vagina]]. This condition can occur as part of a syndrome or as an isolated anomaly. It is often associated with [[Mayer-Rokitansky-Koster-Hauser syndrome]] (MRKH), where the uterus is also underdeveloped or absent.
Vaginal hypoplasia can vary in severity from being smaller than normal to being completely absent.
 
The absence of a vagina is a result of vaginal [[agenesis]]. Diagnostically, it may look similar to a vaginal obstruction such as can be caused by an [[imperforate hymen]] or, less commonly, a [[transverse vaginal septum]].
 
It is frequently associated with [[Mayer-Rokitansky-Küstner-Hauser]] (MRKH) syndrome, in which the most common result is an absent uterus in conjunction with a deformed or missing vagina, despite the presence of normal ovaries and normal external genitalia. It is also associated with [[cervical agenesis]], in which the uterus is present but the uterine [[cervix]] is absent.
 
The situation is most urgent where there is a [[menstruating]] uterus with an obstructed uterovaginal outflow, leading to [[hematometra]]. In this case prompt medical action is required.
 
==Causes==
==Causes==
The main causes are [[Müllerian agenesis]] and [[complete androgen insensitivity syndrome]].<ref name="Callens2014">{{cite journal|last1=Callens|first1=N.|last2=De Cuypere|first2=G.|last3=De Sutter|first3=P.|last4=Monstrey|first4=S.|last5=Weyers|first5=S.|last6=Hoebeke|first6=P.|last7=Cools|first7=M.|title=An update on surgical and non-surgical treatments for vaginal hypoplasia|journal=Human Reproduction Update|volume=20|issue=5|year=2014|pages=775–801|issn=1355-4786|doi=10.1093/humupd/dmu024|pmid=24899229}}</ref>
Vaginal hypoplasia is typically caused by genetic factors that affect the development of the [[Mullerian ducts]], which are precursors to the female reproductive tract. In MRKH syndrome, the exact genetic cause is not fully understood, but it is believed to involve multiple genes.
 
==Diagnosis==
Diagnosis of vaginal hypoplasia is usually made during adolescence when a young woman does not begin menstruating. A physical examination and imaging studies, such as an [[ultrasound]] or [[MRI]], are used to assess the development of the reproductive organs.
==Treatment==
==Treatment==
In order to facilitate [[sexual intercourse]], the main treatments are self-dilation methods (using intra-vaginal cylinders of increasing size) and surgical [[vaginoplasty]] to lengthen the vagina.<ref name="Callens2014"/>
Treatment for vaginal hypoplasia often involves surgical and non-surgical methods to create or enlarge the vaginal canal. Non-surgical options include the use of vaginal dilators, which gradually stretch the vaginal tissue. Surgical options may include the creation of a neovagina using skin grafts or other techniques.
 
==Prognosis==
Self-dilation has a high success rate, estimated at 75%, and is usually the first-line treatment due to low [[Invasiveness of surgical procedures|surgical invasiveness]].<ref name="Callens2014"/> Overall, the complication rates are significantly lower with dilation  than with vaginoplasty.<ref name="Callens2014"/>
With appropriate treatment, individuals with vaginal hypoplasia can lead normal lives, including the possibility of sexual activity and, in some cases, [[gestational surrogacy]] if they wish to have children.
 
Surgery is indicated when there is inability or reluctance to perform self-dilation, or where it is performed but with failed result. One appropriate surgical variant is the ''Vecchietti technique''. In this procedure, an olive-shaped pressure device is pressed towards the potential vaginal space by a thread that goes through the skin, behind the [[urinary bladder]] and [[pubic bone]] and exits the skin in the [[hypogastrium]], where it is attached to a plate that provides counter-traction.<ref name="Callens2014"/> Vaginoplasty can also be performed using a [[skin graft]] or an [[intestinal graft]]. Traction vaginoplasty such as the ''Vecchietti technique'' seems to have the highest success rates both anatomically (99%) and functionally (96%), whereas skin graft procedures and intestinal procedures have the lowest successful outcomes (83–95%).<ref name="Callens2014"/>
 
After vaginoplasty, available evidence suggests that continued self-dilation is needed to maintain patency in periods of coital inactivity.<ref name="Callens2014"/>
 
==Epidemiology==
Vaginal hypoplasia is estimated to occur in 1 in 4,000–5,000 live female births. It is often unnoticed until adolescence when pain and a lack of menstrual flow indicates the condition.<ref>{{citation|title=The Artificial Vagina|author=I Jackson|publisher=Obstetrical & Gynecological Survey|year=1966|url=http://journals.lww.com/obgynsurvey/Abstract/1966/04000/The_Artificial_Vagina.41.aspx}}</ref>
 
==See also==
==See also==
*[[Cervical agenesis]]
* [[Mayer-Rokitansky-KÔøΩster-Hauser syndrome]]
*[[Müllerian agenesis]]
* [[Congenital disorder]]
 
* [[Vaginal agenesis]]
==References==
==References==
{{reflist}}
{{Reflist}}
 
== External links ==
{{Medical resources
|  DiseasesDB    = 13688
|  ICD10          = {{ICD10|Q|52|0|q|50}}
|  ICD9          = {{ICD9|623.2}}
|  ICDO          = 
|  OMIM          = 
|  MedlinePlus    = 
|  eMedicineSubj  = article
|  eMedicineTopic = 954110
|  MeshID        =
}}
*[http://ibis-birthdefects.org/start/vaginal.htm International Birth Defects Information System]
**[http://www.anatomyatlases.org/AnatomicVariants/OrganSystem/Text/Vagina.shtml ''Vagina'', Anatomical Atlases, an Anatomical Digital Library (2018)]
*{{commons category-inline|Vaginas}}
 
{{Congenital malformations of genital organs}}
 
[[Category:Congenital disorders of female genital organs]]
[[Category:Congenital disorders of female genital organs]]
[[Category:Vagina]]
[[Category:Rare diseases]]
[[Category:Rare diseases]]
{{stb}}

Latest revision as of 21:19, 8 April 2025

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Vaginal hypoplasia
Illustration of vaginal hypoplasia
Synonyms Congenital absence of the vagina, Müllerian agenesis
Pronounce N/A
Specialty N/A
Symptoms Absent or underdeveloped vagina, amenorrhea, possible infertility
Complications Infertility, sexual dysfunction
Onset Congenital
Duration Lifelong
Types N/A
Causes Müllerian duct anomalies
Risks Genetic factors
Diagnosis Physical examination, imaging studies
Differential diagnosis Androgen insensitivity syndrome, Mayer-Rokitansky-Küster-Hauser syndrome
Prevention N/A
Treatment Surgical intervention, vaginal dilators
Medication N/A
Prognosis Variable, depending on associated conditions
Frequency Rare
Deaths N/A


A congenital condition affecting the development of the vagina


An inflatable vaginal expander used in treatment
Vaginal expander in use

Vaginal hypoplasia is a congenital condition characterized by the underdevelopment or absence of the vagina. This condition can occur as part of a syndrome or as an isolated anomaly. It is often associated with Mayer-Rokitansky-Koster-Hauser syndrome (MRKH), where the uterus is also underdeveloped or absent.

Causes[edit]

Vaginal hypoplasia is typically caused by genetic factors that affect the development of the Mullerian ducts, which are precursors to the female reproductive tract. In MRKH syndrome, the exact genetic cause is not fully understood, but it is believed to involve multiple genes.

Diagnosis[edit]

Diagnosis of vaginal hypoplasia is usually made during adolescence when a young woman does not begin menstruating. A physical examination and imaging studies, such as an ultrasound or MRI, are used to assess the development of the reproductive organs.

Treatment[edit]

Treatment for vaginal hypoplasia often involves surgical and non-surgical methods to create or enlarge the vaginal canal. Non-surgical options include the use of vaginal dilators, which gradually stretch the vaginal tissue. Surgical options may include the creation of a neovagina using skin grafts or other techniques.

Prognosis[edit]

With appropriate treatment, individuals with vaginal hypoplasia can lead normal lives, including the possibility of sexual activity and, in some cases, gestational surrogacy if they wish to have children.

See also[edit]

References[edit]

<references group="" responsive="1"></references>

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