Related Experiment Video
Updated: Mar 27, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Relieving menstrual obstruction: surgical correction of vaginal agenesis
Jennifer J Schmitt1, Chetna Arora2, John B Gebhart3
1Female Pelvic Medicine and Reconstructive Surgery, Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN, USA. schmitt.jennifer@mayo.edu.
Introduction And Hypothesis:
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome includes vaginal agenesis with varied uterine development. The objective of this video is to illustrate our surgical technique to create a cervical and vaginal canal to relieve menstrual obstruction for a teenager with a functional uterus and vaginal agenesis.
Methods:
Using vaginal dissection and a mini laparotomy, a sound placed through the fundus of the uterus created an endocervical and vaginal channel to relieve her menstrual obstruction. A Foley catheter stented the cervical canal and a red rubber chest tube catheter stented the vagina until epithelization was achieved.
Results:
No complications were encountered. The patient was examined with intermittent hysteroscopy with gentle dilation of the cervix. She had the red rubber catheter removed at 3 months, and she started using a small dilator. Her menses were suppressed with a gonadotropin releasing-hormone agonist allowing for complete healing. She is now 17. Her vaginal canal is well-epithelialized. Hysteroscopy confirmed a patent endocervical canal and uterine cavity.
Conclusion:
MRKH is rare. A small percentage of affected women has a functional endometrium requiring intervention for menstrual obstruction. Full vaginal reconstruction may be considered, but creation of a small canal to provide menstrual relief can be a temporary solution in those not desiring sexual function.
