Congenital vaginal obstruction occurs when the hymen (a membrane that surrounds the vaginal opening) has not formed properly and instead of surrounding the vagina, it completely covers it. This is known as an imperforate hymen.
Congenital vaginal obstruction can also occur when the vaginal canal has failed to develop properly during gestation. This is called a high transverse septum.
Both of these anomalies can cause symptoms for your baby. These are:
Swelling of the vagina
Swelling of the uterus
Swelling of the abdomen due to secretions from the cervical glands filling up the vagina with fluid
Urinary difficulties or obstruction can occur.
Ideally the condition will be diagnosed at birth or shortly afterwards, however, some patients are missed and the problem is not noticed until puberty. Affected girls will be unable to have a menstrual bleed.
Although they will ovulate normally, there is no exit for the menstrual flow to leave their body. They may experience monthly abdominal pain and swelling due to blocked menstrual blood backing up and having nowhere to go.
Undiagnosed congenital vaginal obstruction can be dangerous and even fatal. The Journal of Pediatric and Adolescent Gynecology reported that one patient died when her condition was undiscovered and she developed an overwhelming infection.
Occasionally, the malformation is not detected until adulthood when the adult presents to the doctor, unable to have intercourse. Some people with congenital vaginal obstruction also have infertility, but many are able to have children once the problem has been fixed. It depends on the extent of the malformation.
Diagnosis is carried out by:
The doctor may find a swollen abdomen.
The cause of the abdominal mass can be confirmed on ultrasound.
Fine Needle Aspiration
A needle can be inserted into the abdomen to drain off fluid for analysis or to add dye so that an X-ray examination can be performed.
Some children present with minimal symptoms and may not have any swelling or urinary retention. If this is the case, their condition may be missed.