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Thus, ironically, procedures designed to promote adjustment and normalcy for these patients can instead result in psychosexual problems.Nonsurgical Approach Currently, the two most popular methods for creating a vagina in these cases are the nonsurgical Frank Procedure and the Mc Indoe split-thickness skin-graft vaginoplasty.Vaginal agenesis may be inappropriately diagnosed as an imperforate hymen, and misguided attempts at hymenotomy may result in secondary scar formation.This mismanagement can lead to treatment difficulties in the future.Vaginal agenesis, which occurs in approximately 1 in every 5,000 to 7,000 female births, is a significant threat to the mental health and well-being of an otherwise normal, healthy young woman.More than 90% of patients with vaginal agenesis fulfill the criteria for the Rokitansky-Kuster- Hauser syndrome-ie, 46, XX karyotype with normal, functioning ovaries.

The patient should be told that she was born with an incompletely developed vagina; the expression "born without a vagina" should be avoided.

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Sallie Foley, ACSW Senior Clinical Social Worker Department of Social Work University of Michigan Medical Center/Ann Arbor George W. Care and Counseling of the Patient with Vaginal Agenesis. Republished with kind permission from The Female Patient.

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