AUA Summit - Congenital Vaginal Obstruction

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Congenital Vaginal Obstruction

Vaginal blockages at birth are rare but must be fixed with surgery. Most female infants are born with a thin layer of issue (hymen) that incompletely covers the vaginal opening.

Causes

The most common cause of an obstructed vagina is an “imperforate” hymen that is lacking any opening. Less often (1 in 70,000) the vagina can be obstructed from a “septum” or thin layer of tissue inside the vagina. Either of these issues can lead to swelling of the vagina and uterus.

Symptoms

Symptoms depend on the level of obstruction. If the baby is born with imperforate hymen, the retained mucus secretions will cause a white or yellow bulge visible in the genital area. If the obstruction is higher (septum), swelling in the lower abdomen is usually noted.

Diagnosis

It is most often found in a newborn. The doctor finds abdominal or genital swelling because the vagina is filled with fluid. An ultrasound or MRI can confirm the cause of the swelling.

If there is no mass or urinary problems, vaginal obstruction might not be found until puberty. At that time, the girl will not pass blood during her period. She may also have pain and swelling that comes and goes from the buildup of menstrual blood behind the obstruction.

Treatment

If the patient has an imperforate hymen, the urologist may need to open the hymen.

If the patient has a septum, treatment will depend on its thickness and location. For more details, check out the Vaginal Fusion web article.

After Treatment

Many parents have questions about their child’s future quality of life and fertility. Once this blockage is fixed, a normal, enjoyable sex life is usually possible.

Fertility should not be affected if the reproductive tract is normal. A C-section may be recommended if a septum was the problem.

Updated March 2024.


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