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Surgical Correction of Vaginal Anomalies

MILLER, RACHEL J. MD; BREECH, LESLEY L. MD

Clinical Obstetrics and Gynecology: June 2008 - Volume 51 - Issue 2 - p 223-236
doi: 10.1097/GRF.0b013e31816d2181
Pediatric and Adolescent Gynecology

Summary of accurate diagnosis and surgical management of vaginal anomalies. Imperforate hymen, transverse septa, and distal vaginal agenesis present similarly with pain and hematocolpos. Likewise, imperforate hymen, transverse septa, distal vaginal agenesis, and Müllerian aplasia may appear similarly on examination. Imaging should be used to better differentiate the anomaly. Although surgical correction is the mainstay of hymenal anomalies, septa, obstructed hemivaginas, and distal vaginal agenesis, first-line therapy for Müllerian aplasia is progressive dilation. Many surgical techniques are also described but no consensus exists as to the best one. Clinicians should be aware of the appropriate evaluation, differential diagnosis, and management options available for vaginal anomalies.

Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio

Correspondence: Rachel J. Miller, MD, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 4000, Cincinnati, OH 45229. E-mail: rachel.miller@cchmc.org

© 2008 Lippincott Williams & Wilkins, Inc.