Congenital Absence of the Vagina

Abstract

Fourteen patients with congenital absence of the vagina associated with a variable abnormality of the uterus are described and the literature is reviewed. Associated developmental anomalies of the urinary tract and skeleton are common. Analysis of 2 affected families suggests that the disorder may represent the variable manifestation of a single underlying genetic defect that can be expressed alone or in any combination of vertebral, renal and genital abnormalities. Some affected persons may have lethal manifestations such as absence of both kidneys and some cases may result from multifactoral causes rather than a single gene defect. Whatever the cause, the defect involves mesodermal development and the mesonephric kidney, the latter resulting in abnormalities in the paramesonephros (uterous and vagina) and in the metanephric kidney. Both nonoperative and surgical treatments are generally successful in repairing the vaginal abnormality.