High vaginal atresia: surgical considerations

Abstract

During the past 15 years, six patients have been treated for high vaginal atresia in the Surgical Unit of the Department of Pediatrics, University Medical School of Pecs, Hungary. In three of the patients distal atresia of the vagina was found (type III); two of the three were neonates and had a large hydrometrocolpos and the third, a 13-year-old girl, had a hematometrocolpos. In the fourth patient the vaginal atresia was associated with a cloacal and anorectal malformation (type V). In the fifth there was a duplication of uterus and vagina; however, only one of the two vaginas was atretic. In the sixth patient the vaginal occlusion was not congenital but acquired. In three patients a pull-through of the vagina was carried out; in one the procedure according to Pena and in another a transvesical approach according to Monfort was used. In the patient with a cloacal malformation, the vagina was replaced by large intestine in several stages. In the patient with duplication of the vagina and uterus one-half of the duplication was removed. The acquired occlusion was treated by the abdominoperineal approach.