Distal vaginal agenesis and differential diagnosis of other causes of hematocolpos

Czech version

Authors: P. Hobzová ^1,2; Nikoleta Chubanovová ¹; Marta Nováčková ¹
Authors‘ workplace: Gynekologicko-porodnická klinika 2. LF UK a FN Motol, Praha ¹; Gynekologicko-porodnické oddělení, Nemocnice Havlíčkův Brod, p. o. ²
Published in: Ceska Gynekol 2022; 87(5): 350-355
Category: Review Article
doi: https://doi.org/10.48095/cccg2022350

Overview

Distal vaginal agenesis is an obstructive congenital malformation of the female reproductive tract. The distal part of the vagina is replaced by fibrous tissue and the outflow of the menstrual blood and secretion of the cervical glands is disabled. This congenital anomaly most often manifests during expected menarche by primary amenorrhea and cyclic lower abdominal pain caused by cryptomenorrhea with gradually increasing hematocolpos and hematometra. The diagnosis is based on gynecological examination and the suspected anomaly is confirmed by ultrasound examination and magnetic resonance imaging. Therapy of distal vaginal agenesis is exclusively surgical. A pull-through vaginoplasty is the method of choice for distal vaginal agenesis not exceeding 3 cm. With a greater extent of agenesis and the risk of postoperative vaginal stenosis, replacement of the missing part of the vagina with other tissues or modified balloon vaginoplasty can be used. The aim of the treatment is to enable the evacuation of the menstrual blood, ensure quality sexual intercourse and the possibility of reproduction.

Keywords:

hematocolpos – distal vaginal agenesis – distal vaginal atresia – hematometra – pull-through vaginoplasty

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