Vaginal atresia and cryptomenorrhea

Six cases of congenital vaginal atresia are described. Three of these patients had cryptomenorrhea while the other 3 had severe coital difficulties. Despite the fact that normal coitus was impossible in these 3 women, 2 of them achieved successful pregnancies and had to be delivered by emergency cesarean section followed by resection of the occluding membranes. The third patient (with dyspareunia) resorted to paraurethral coitus for more than 2 years before seeking advice. The management of vaginal atresia proved difficult because of the recurrence of stenosis at the site of the excised membrane. This was particularly marked in the young adolescent females not exposed to regular coitus. An operative method that could minimize this complication is discussed.