If there is agenesis of the lower vagina and there is a normal, functional upper vagina and uterus, than the upper vagina will fill with blood during menstruation. This can create a large pelvic mass which is the distended upper vagina.

It is Children's Hospital Boston's recommendation that a surgical procedure be performed when the upper vagina is filled with blood so that the upper vagina can be brought down to the area where a normal vaginal opening should occur. This is called a "pull-through vaginoplasty." A pull-through vaginoplasty will thus create a normal vagina. The tissue of the upper vagina which has been distended with blood has been expanded so that the upper vagina can now reach the lower vagina.

If this procedure is not performed when the upper vagina is filled with blood, than there may not be enough vaginal tissue to bring it down to the area of the hymeneal opening. If this is the case, then someone may need a procedure with the placement of a skin graft or section of bowel in order to create a normal length to the vagina. Once a normal vagina has been created a vaginal dilator may need to be worn in order to decrease the risk of circumpherential scar tissue formation. Once corrected, a woman with agenesis of the lower vagina should have normal reproductive function and fertility.

For more information go to the Center for Young Women's Health website.