Most congenital anomalies of the vagina are rare. Vaginal anomalies include vaginal agenesis, obstruction, duplication, and fusion. Duplication and fusion anomalies have numerous manifestations (eg, as 2 uteri, 2 cervices, and 2 vaginas, or 2 uteri with 1 cervix and 1 vagina). Girls may also have urogenital sinus anomalies, in which urinary and genital tracts open into a common channel, and cloacal anomalies, in which urinary, genital, and anorectal tracts open into a common channel.
Imperforate hymen manifests as a bulge at the location of the vaginal opening due to collection of uterine and vaginal secretions caused by maternal estrogens. Treatment is surgical drainage.
Diagnosis of most is by physical examination, ultrasonography, and retrograde contrast studies. Duplication and fusion anomalies may not require treatment, but others require surgical correction.
Last full review/revision January 2010 by Ronald Rabinowitz, MD