Management of congenital absence of the vagina

The management of congenital absence of the vagina is facilitated where there is knowledge and understanding of any associated genetic, metabolic, and morphologic anomalies. Although the McIndoe split-thickness graft operation was the most commonly used method (15 patients), other surgical and nonsurgical alternatives were selectively utilized. In 10 women where a functioning uterus was present, laparotomy was necessary in six because of obstruction to uterine drainage. In the choice of treatment method to establish a functioning vagina, individualization is important, but certain guiding principles found to be useful are discussed.