Vaginal abnormalities are rare congenital defects that cause an abnormal or absent vagina. They are aberrant structures that occur (or do not form) during the foetal development of the female reproductive system. They are frequently discovered with uterine, skeletal, and urinary abnormalities when they are present. This is because certain structures, like the vagina, are more vulnerable to being disturbed at critical stages of organ genesis. Numerous of these flaws fall under the umbrella category of Müllerian duct abnormalities. A disruption in genitourinary development during the embryonic stage is what leads to Müllerian duct abnormalities. The other isolated cases of vaginal abnormalities can happen for unknown reasons. Vaginal abnormalities frequently belong to a group of diseases or syndromes. Inheritance and prenatal exposure to some teratogens may also have an impact.
An anomaly of the vagina may not have an impact on other reproductive organs. Even if the vagina and external genitalia are damaged, the uterus, fallopian tubes, and ovaries can still function. The fertility may not be impacted by a vaginal abnormality.
Conception is possible, though it depends on how severe the vaginal abnormality is. If an ovary is functioning, IVF might work in some cases.
A woman with a vaginal deformity who has functioning ovaries can implant a fertilised ovum into the uterus of an unaffected gestational carrier, generally another person. It is possible to conceive successfully. The length of the vagina ranges from 6.5 to 12.5 cm. It may affect the diagnosis of women with vaginal agenesis or hypoplasia who may be unnecessarily urged to seek treatment to enlarge the vagina because this description is a little bit shorter than older descriptions. Vaginal abnormalities can make it difficult to urinate, get pregnant, or have intercourse. Also possible are psychosocial repercussions.
Signs and symptoms
When an individual is examined soon after birth or when the development of their sexual features does not proceed as predicted, some anomalies are discovered. Amenorrhea makes defects that restrict menstrual flow.
Since syndromes are uncommon and frequently include metabolic abnormalities, diagnosing them may take longer. Similar indications and symptoms are present in many disorders.
Associated uterine defects
Vaginal abnormalities may be accompanied by uterine defects:
- Agenesis Müllerian (absent uterus). The vagina is either nonexistent or only minimally developed, and the uterus is not.
- Also known as the uterine Didelphis (double uterus). Vaginal transverse septum
- Octagonal uterus (uterine septum or partition). with a fully developed vaginal septum
- A remnant of the uterus that isn’t connected to the cervix and vagina is known as the primitive uterus.
- Unilateral renal agenesis and other renal abnormalities may be present in women with uterine abnormalities.
It is not always possible to identify the exact aetiology of isolated vaginal malformations, although disturbance of the vagina’s embryonic development most definitely plays a major role.
The most effective imaging procedures, particularly retrograde contrast investigations, are typically those used to diagnose vaginal abnormalities. Especially in identifying the existence of urogenital syndrome, an abnormality scan can be significant. Additional testing is needed to confirm a diagnosis of genetic and metabolic abnormalities.
An operation is used to treat vaginal abnormalities. It is possible to create a “neo-vagina” for girls and women who lack a vagina. Surgery is used to treat vaginal septa.
An imperforate hymen is the most typical vaginal abnormality. Some paediatricians can spot these abnormalities soon after birth since it occurs frequently enough. Up until puberty, an imperforate hymen may not be rectified. The presence of fibrous bands of tissue can cause the hymen to be particularly thick or partially blocked. Other abnormalities, such as septa, can also be present in an imperforate hymen. An imperforate hymen may not be where it is supposed to be and can move about. There may also be other hymen abnormalities, such as septa, displacement, and a hymen with micro-perforations. A double hymen is unusually present. Treatment for the imperforate hymen involves excision and drainage. Around the vaginal opening, a thin border of hymenal tissue occasionally remains.
The abnormal development of the vagina can be brought on by congenital adrenal hyperplasia. The abnormal presence of cervical and uterine tissue within the vaginal wall is known as vaginal adenosis. 10% of women have this condition but show no symptoms. Rarely does it progress to malignancy when there are two vaginas, the disorder is known as cloacal exstrophy. One in every 5,000 women has vaginal agenesis, which is the complete lack of the vagina.
A hemivagina is a partial vagina that is abnormally present and connected to the wall of the healthy vagina.
The hemivagina is joined to an aberrant second uterus and does not open to the normal vagina. In cases of full androgen insensitivity syndrome, the vaginal tissue is underdeveloped and is known as vaginal hypoplasia. Vaginal septa are fibrous tissue-based structures that obstruct the vagina. The tissue spreads transversely, basically forming two vaginas that link to a typical uterus, or horizontally, blocking or partially blocking the vaginal canal. Even while some women do not experience symptoms, septa can cause the menstrual flow to stop and can result in painful intercourse. Because the external genitalia can seem normal at birth, many vaginal defects go undetected.