Vaginal Atresia: Causes, Symptoms, Diagnosis & Treatment

Vaginal atresia is a rare birth condition where the vaginal canal is either partially or completely blocked due to improper development.

This can lead to complications like difficulty in menstruation, fertility issues, and urinary problems.

Early diagnosis and proper treatment are essential to improve health and quality of life.

What is Vaginal Atresia?

Vaginal atresia is a condition present from birth where the vaginal passage is either absent or blocked, preventing normal menstrual flow and sexual function.

It occurs when the Müllerian ducts do not develop properly during pregnancy. Depending on the severity, treatment options include surgical and non-surgical methods to create a functional vaginal canal.

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Difference Between Agenesis and Atresia

Both agenesis and atresia are congenital conditions that affect the reproductive system, but they have key differences:

Agenesis: This means the complete absence of an organ due to failure in development. In vaginal agenesis, the vaginal canal is completely missing, and in some cases, the uterus may also be underdeveloped or absent, as seen in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
Atresia: The organ is present but has a blockage in this condition. In vaginal atresia, the vaginal passage is partially or completely closed, though some vaginal tissue exists.

Types of Vaginal Atresia

Vaginal atresia can be of different types based on the severity of the blockage:

Partial Vaginal Atresia: A portion of the vaginal canal is closed, but some part remains open.
Complete Vaginal Atresia: The entire vaginal canal is absent, making menstruation and sexual intercourse difficult.
Vaginal Agenesis: A more severe condition where both the vagina and sometimes the uterus are not developed.

Symptoms of Vaginal Atresia

Symptoms usually become noticeable during puberty and include:

No menstrual periods despite other puberty signs
Pelvic pain due to trapped menstrual blood (cryptomenorrhea)
Difficulty during sexual intercourse
Urinary problems, such as infections or difficulty urinating
Reproductive issues, depending on whether the uterus is affected

Causes of Vaginal Atresia

The exact cause is not known, but it is linked to:

Congenital disabilities: Improper formation of the Müllerian ducts during pregnancy
Genetic factors: Family history of reproductive system abnormalities
Hormonal imbalances: Affecting the development of reproductive organs

Diagnosis of Vaginal Atresia

Doctors use several methods to confirm the condition:

Physical Examination: To check if the vaginal opening is present
Ultrasound: To examine internal reproductive organs
MRI or CT Scan: Provides a clearer image of the vagina and uterus
Hormonal Tests: To rule out other puberty-related conditions

Treatment Options for Vaginal Atresia

The treatment depends on the severity of the condition and the patient’s needs:

Non-Surgical Treatment

Vaginal Dilators: In some cases, special medical devices called dilators are used to expand the vaginal canal gradually.

Surgical Treatment

Vaginoplasty: Surgery to create or reconstruct the vaginal canal.
McIndoe Procedure: Uses skin grafts to form a functional vagina.
Vecchietti Procedure: A minimally invasive method using gradual stretching to create a vaginal canal.
Bowel Vaginoplasty: In severe cases, a section of the intestine is used to form a vaginal passage.

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Risk Factors of Vaginal Atresia

Certain factors may increase the risk of developing vaginal atresia, such as:

Family history of reproductive system abnormalities
Genetic disorders like MRKH syndrome
Hormonal imbalances during fetal development
Other congenital disabilities affecting the reproductive or urinary system

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Frequently Asked Questions

Vaginal atresia can present with primary amenorrhea, cyclic lower abdominal pain, and a bulging mass in the pelvis. A pelvic exam confirms the diagnosis.

Do: Consult a gynecologist, consider surgical options, attend counseling. Don't: Delay seeking medical help, attempt self-treatment, ignore emotional impact.

Serious complications of vaginal atresia include menstrual problems, infertility, and difficulty with sexual intercourse. Early diagnosis and treatment are important.

Surgery is the main treatment for vaginal atresia to open or create a new vagina. Dilators may be used post-surgery to prevent re-narrowing.

Vaginal atresia is not likely to come back after surgical treatment. Regular follow-ups are important for monitoring and managing any potential complications.