Corrección quirúrgica de la agenesia vaginal

Background: Vaginal agenesis is a rare congenital disorder. It requires surgical management and still it is not defined universally. The surgical resolution of the pure vaginal agenesis, through fasciocutaneous pudendal thigh flaps, has few complications and allows the copulative function in normal conditions. Objective: To assess the results of the vaginal agenesis surgical management. Patients and methods: From January 1996 to January 2005 we identified 33 patients with Mullerian duct and urogenital sinus disorders; eight of them had vaginal agenesis diagnosis. All the patients were subject to: complete medical history, karyotype study, determination of a complete gynecological profile, pelvic ultrasound, excretory urography, and, in some acute cases of hematometra or hematosalpinx, to an intervention with two surgical equipments: one of them used for the hematic collection emptiness of the internal genitals and the other one to solve the mechanical obstruction of vaginal agenesis. In some cases the study was completed through diagnostic laparoscopy. Results: In our series six patients had functional uterus. When we made the surgical intervention we tried to make the uterus tunelization in the neovagina through the use of a Foley catheter. Nevertheless, they continued with symptoms of cyclical pelvic pain and chronic hematometra. One of the patients was exposed to total abdominal hysterectomy without bilateral oophorectomy, and in two more we are planning to make the same procedure in a short term. Conclusions: Fasciocutaneous pudendal thigh flaps technique is easy, safety and reliable, and it allows the creation of a neovagina in only one surgical time.