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These pages are presented for information purposes only and should never be used as a substitute for a full and proper consultation with a suitably Qualified Medical Practitioner. Furthermore all information in this website is merely intended to be of a general nature and is provided solely for the interest of the reader. Femistent does not accept any responsibility whatsoever for its use. For further details, please refer to the  Femistent Terms and Conditions.

Vaginal Agenesis

What is Vaginal Agenesis? | Treatment | Long Term fertility | Use of Vaginal Dilators


What is Vaginal Agenesis?

Vaginal agenesis is a birth defect or congenital disorder which affects a relatively small proportion of women, some 1 in 5,000 – 7,000, or about 0.025%. It is primarily a physical abnormality of the vagina which, for some reason, stops developing. Technically this condition is called the Mayer-Rokitansky-Kuster-Hauser Syndrome. Typically sufferers have a short vagina of maybe 3.5cm or 1.5” in length, but there might be no vagina at all. Also, it is not uncommon to have other malformations in the reproductive tract as well. But most of those afflicted do have normally functioning ovaries, and some 5% of those afflicted have a normally functioning uterus.

A relatively small proportion of sufferers also have testicular tissue present. The incidence of this condition can amplify significantly issues of body image, sexual identity, sexual relationships and childbearing, all of which may require professional medical and psychological treatment, and this should not only be extended to those afflicted, but should also include the parents and others if appropriate.

However, since much of the female pleasure within a sexual encounter can result from stimulation of the clitoris which is the female erectile structure, and not the vagina itself, it is often possible for a sufferer eventually to enjoy normal sensations and a good sex life after appropriate treatment.

Since whilst the sufferer is young the genitalia appear normal externally, vaginal agenesis is often not diagnosed until puberty (typically about 14), when it is noticed that the first menstrual cycle has not commenced and, as a result, advice is sought. The initial diagnosis is made with a physical examination, probably followed by further investigations using chromosomal, intravenous, and X-ray tests, ultrasound or MRI.


What is Vaginal Agenesis? | Treatment | Long Term fertility | Use of Vaginal Dilators



There are typically two main forms of treatment for vaginal agenesis sufferers. Vaginal dilation, where sufferers’ symptoms are not severe enough to warrant invasive surgery, and for those who do require vaginoplasty (see section on this website) or other vaginal surgery. This surgery is also usually followed by a period of vaginal training using appropriate dilators.

In cases where non-surgical treatment is adequate, the 'Frank' or the now preferred 'Ingram' techniques are typical of the approaches adopted. Essentially a professional medical dilator is pushed into the vaginal cavity for sessions of about 20 to 30 minutes, perhaps several times daily. With the correct pressure applied over time, using professional dilators of increasing length and diameter, an acceptable vagina can often be created. Regular, typically monthly, consultation with an experienced therapist during this time is imperative. In many cases, long term treatment of this type can be very successful, although the motivation and commitment of the sufferer is of considerable importance.

Vaginoplasty is an invasive surgical procedure which, regrettably, is often necessary in order to adequately treat vaginal agenesis sufferers. Different surgeons use different techniques, but there are essentially two ways in which the procedure can be performed. The first ('McIndoe') technique is where a split-thickness skin graft (i.e. where the surgeon uses the outer layer of skin from one part of the body to create a covering for elsewhere) is taken from a donor site, typically from one of the upper thighs, and from this a tube is formed. This tube is then inserted into where the vagina should be, possibly by making an incision first. Following typically a week of bed rest, vaginal dilation will be started.

The second technique is when a section of the lower colon is removed through an abdominal incision. One end of the sectioned colon is then closed, whilst the remaining open end is sutured into place behind the vaginal opening, again resulting in the creation of a neo-vagina. A period of vaginal dilation will be necessary following this procedure as well, but there is no need to insert the dilator so close to the end of the neo-vagina during the first few weeks following surgery. It should be noted that some mucous discharge may come out from neo-vaginas constructed in this way, since this is a natural secretion from the inside colon mucosa. Furthermore, this surgical procedure is both more complicated and more invasive than that described earlier.

Vaginal agenesis sufferers who have had the skin graft procedure performed will usually have to use dilators of several months after surgery, indeed they may well find it necessary to use them for the rest of their lives during which they wish to have an active sex life. Vaginal stenosis, or tightening / shortening of the vagina (see elsewhere in this site for further information) is a frequent complication with this procedure, but this can usually be largely offset through correct use of professional dilators.

However, those who have had colon vaginoplasty usually have to dilate less frequently, although they also are likely to have to dilate to some degree for the time during which they wish to remain sexually active.

In both cases, maintaining a high degree of neo-vaginal cleanliness is essential, as is adequate consultation with a suitably qualified therapist.


What is Vaginal Agenesis? | Treatment | Long Term fertility | Use of Vaginal Dilators


Long Term fertility

Regardless of the actual treatment undertaken, the eventual ability of the sufferer to have children will depend entirely on the actual anatomy of the person concerned. If the sufferer has a normal uterus, ovaries and fallopian tubes, a normal pregnancy might well be possible. Also where only ovaries are present, it might be possible to harvest some eggs, fertilize them with her partner’s sperm, and then implant this into a surrogate mother. Otherwise, adoption is likely to be necessary.


What is Vaginal Agenesis? | Treatment | Long Term fertility | Use of Vaginal Dilators


Use of Vaginal Dilators

Dilators likely to be suitable for use by those being treated for Vaginal Agenesis may be purchased on www.soulsource.com. However, it is very important for you to discuss such purchases and the use of such dilators with your Qualified Medical Practitioner, and that you follow their directions for use carefully and precisely.