Treating Müllerian Anomalies
Müllerian anomalies are structural abnormalities that occur in the uterus, cervix or vagina. These anatomical abnormalities happen due to problems occurring as the reproductive system is developing in the female fetus in the womb. They can be as complex as a dual system (2 uteri, cervices and vaginal canals) called a ‘didelphys’ or as simple as an imperforate hymen.
About Müllerian Anomalies
What are Müllerian Anomalies? And what can be the consequences if you suffer from this disorder?
Learn more about hormonal management in paediatric gynaecology.
Menstrual Disorders in Adolescents
Learn more about Menstrual Disorders in young girls.
Many of the management options for treating müllerian anomalies involve surgery to either remove tissue that is causing problems (e.g. an obstructed hemi uterus causing cyclical pain) or to create functionality (e.g. hymenectomy for imperforate hymen).
One abnormality is known as Uterine Agenesis which is an absence of uterus and cervix and a shortened vaginal length. Both ovaries are present.
Vaginal agenesis Treatment
Depending on your individual condition, your specialist may recommend a non-surgical or surgical treatment. It is best planned when you are emotionally mature and when you have expressed the desire for a correction.
As a first step, your specialist will recommend dilation. This allows you to create a vagina without surgery. You press a dilator, a plastic round-tipped cylinder, against your skin or inside your existing vagina for at least 30 minutes a day. As the weeks go by you use larger dilators. After a few months you might get to the result you want.
If dilation doesn’t work for you, you may have surgery. There are multiple options. The most common surgical procedure is called Abbe-McIndoe. In this procedure the surgeon uses skin from your buttocks to create a vagina, inserts the skin graft to create the structure and places a foam-rubber mold into the newly formed canal. One week after the surgery, the mold is removed. And from then onwards you use a dilator to maintain a functional vagina. After a few months you use the dilator only at night.
Other procedures for the creation of the neovagina are the Vecchietti procedure and other laparoscopic modifications of operations previously performed by laparotomy.
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