Mullerian agenesis

The Committee on Adolescent Health Care of the American College of Obstetricians and Gynecologists (ACOG) has issued an opinion paper on nonsurgical diagnosis and management of vaginal agenesis. ACOG Committee Opinion No. 274 appears in the July 2002 issue of Obstetrics and Gynecology.

According to the ACOG opinion paper, vaginal agenesis is an uncommon, but not rare, condition. It occurs once in every 4,000 to 10,000 females. The most common cause of vaginal agenesis is congenital absence of the uterus and vagina, which is also referred to as mullerian aplasia, mullerian agenesis, or Mayer-Rokitansky-Kuster-Hauser syndrome. The condition usually can be managed nonsurgically with the use of successive dilators if it is correctly diagnosed and the patient is sufficiently motivated.

Besides correct diagnosis, effective management also includes evaluation for associated congenital, renal, or other anomalies and careful psychologic preparation of the patient before any treatment or intervention. The ACOG committee recommends that nonsurgical creation of the neovagina should be the first-line approach. If surgery is preferred, a number of approaches are available and described in the Committee Opinion; the most common is the Abbe-McIndoe operation.

COPYRIGHT 2002 American Academy of Family Physicians
COPYRIGHT 2002 Gale Group