[Congenital vaginal atresia: report of 16 cases]

To analyze the clinical features of congenital vaginal atresia (CVA) with normal uterine corpus and investigate the relationship between the subtypes and management.

Sixteen cases, partical atresia (type I) 10 and complete atresia (type II) 6, treated in Peking Union Medical College Hospital, during the past 16 years, were analysed retrospectively.

Patients with type I CVA had an earlier onset of symptoms [(13.0 +/- 1.1) years of age], duration of [(3.5 +/- 2.4) months], greater pelvic masses [(7.7 +/- 3.0) cm in diameter] with lower location as compared with type II CVA [(15.5 +/- 3.4) years of age, 24.0 months, (5.3 +/- 1.0) cm in diameter, P < 0.01]. Distal colpoplasty was performed on 10 type I cases and vaginal mold was placed postoperatively. Dysmenorrhea relieved in all cases during median 21 month follow-up. Vaginal dilatation was done in 4 cases due to readhesion and constriction. One out of the 2 married patients delivered viable neonate by cesarean section. Three out of 6 type II patients were complicated with either endometriosis or hematosalpinx or double uterus. Hysterectomy with or without colpoplasty was done. While the other 3 underwent colpoplasty and cervical canalization. Only 2 had menses after operation, but 1 of the developed dysmenorrhea, ovarian endometrioma and was treated surgically again, the other 1 had hypomenorrhea.

Patients with type I CVA had better outcomes after colpoplasty if they persist on placing vaginal mold. While for type II CVA, hysterectomy usually needed in most cases.