SUCCESSFUL PULL-THROUGH VAGINOPLASTY FOR DISTAL VAGINAL AGENESIS: A CASE REPORT

Distal vaginal agenesis is a rare malformation of the vagina, resulting in genital outflow tract obstruction. Thorough history taking and physical examination, supplemented by diagnostic imaging are essential to arriving at an accurate diagnosis and appropriate management plan. We are presented with an amenorrheic, 13-year old patient who complained of pelvic pain. Perineal inspection revealed a pink dimple at the area of the introitus, with an intact hymenal fringe, and no vaginal opening. Magnetic Resonance Imaging (MRI) of the genitourinary tract and transrectal with transperineal ultrasound showed presence of hematometra and hematocolpos, consistent with distal vaginal agenesis. She underwent Pull-through vaginoplasty, excision of vaginal septum, with evacuation of hematocolpometra. An innovational vaginal stent, using a 10mL syringe barrel, pierced with holes was left in-situ to keep the vagina patent, while allowing drainage of blood. The patient tolerated the procedure well and was able to achieve regular menstrual flow following surgery.