eMedicine Specialties > Pediatrics: Surgery > Gynecology

Vaginal Atresia: Follow-up

Author: Amulya K Saxena, MD, Attending Pediatric Surgeon, Department of Pediatric Surgery, Medical University of Graz, Austria
Coauthor(s): Martin I Herman, MD, FACEP, FAAP, Professor, Department of Pediatrics, Division of Critical Care and Emergency Medicine, University of Tennessee Health Sciences Center; President, Pediatric Emergency Services Specialists, PC; Assistant Medical Director of Emergency Services, LeBonheur Children's Medical Center; Elizabeth A Paton, RN, MSN, NP, CS Nurse Practitioner, Department of Emergency Medicine, Le Bonheur Children's Medical Center
Contributor Information and Disclosures

Updated: Dec 11, 2008

Outcome and Prognosis

Variations in patients' anatomic findings and the lack of a standardized surgical technique complicate the outcomes and prognostication. Reconstruction for vaginal atresia is frequently reported with other conditions that result in an abnormal perineum (ie, ambiguous genitalia and various anomalies ranging from urogenital sinus to cloaca). Therefore, accurate comparison of outcomes is difficult.

In addition, gender-identify issues in patients treated for ambiguous genitalia occasionally confound the patient's satisfaction from a cosmetic and functional standpoint. An increasing focus on the functional and psychological aspects of these reconstructive operations may help in identifying patients who are best suited to receive specific surgical techniques. This focus may also help in delineating the timing of interventions.

Future and Controversies

The complexities of the regulation of developmental processes are now becoming sufficiently clear to allow speculation regarding future intervention with specific modulators (eg, clinical evaluation of the effects of intervention by using müllerian-inhibiting substance [MIS]).

An alternative strategy may rely on advances in surgical techniques and on the application of homografts derived from advances in tissue engineering, which allow for reconstruction by using site-specific tissues.26

 


More on Vaginal Atresia

Overview: Vaginal Atresia
Workup: Vaginal Atresia
Treatment: Vaginal Atresia
Follow-up: Vaginal Atresia
References
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References

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Further Reading

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Keywords

vaginal atresia, vaginal agenesis, Rokitansky-Mayer-Küster-Hauser syndrome, RMKH, Rokitansky-Mayer syndrome, Rokitansky syndrome, Rokitansky's syndrome, müllerian agenesis, McKusick-Kaufman syndrome, MKKS, Bardet-Biedl syndrome, BBS, absent vagina, uterovaginal outflow tract obstruction, vaginal obstruction, transverse vaginal septum, müllerian-inhibiting substance, MIS, amenorrhea, hydrometrocolpos, postaxial polydactyly, imperforate anus, congenital heart defects, secondary endometriosis

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Contributor Information and Disclosures

Author

Amulya K Saxena, MD, Attending Pediatric Surgeon, Department of Pediatric Surgery, Medical University of Graz, Austria
Amulya K Saxena, MD is a member of the following medical societies: European Pediatric Surgeons Association, German Society of Pediatric Surgery, German Society of Surgery, and International Pediatric Endosurgery Group
Disclosure: Nothing to disclose.

Coauthor(s)

Martin I Herman, MD, FACEP, FAAP, Professor, Department of Pediatrics, Division of Critical Care and Emergency Medicine, University of Tennessee Health Sciences Center; President, Pediatric Emergency Services Specialists, PC; Assistant Medical Director of Emergency Services, LeBonheur Children's Medical Center
Martin I Herman, MD, FACEP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Medical Association, and Tennessee Medical Association
Disclosure: Nothing to disclose.

Elizabeth A Paton, RN, MSN, NP, CS Nurse Practitioner, Department of Emergency Medicine, Le Bonheur Children's Medical Center
Elizabeth A Paton, RN, MSN, NP is a member of the following medical societies: American Academy of Nurse Practitioners, American Academy of Pediatrics, Emergency Nurses Association, and Sigma Theta Tau International
Disclosure: Nothing to disclose.

Medical Editor

Elizabeth Alderman, MD, Director of Fellowship Training Program, Director, Adolescent Ambulatory Service, Clinical Professor, Department of Pediatrics, Division of Adolescent Medicine, Albert Einstein College of Medicine and Montefiore Medical Center
Elizabeth Alderman, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, North American Society for Pediatric and Adolescent Gynecology, and Society for Adolescent Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Wayne Wolfram, MD, MPH, Clinical Associate Professor, Departments of Pediatrics, Children's Hospital and University of Cincinnati
Wayne Wolfram, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Pediatrics, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

H Biemann Othersen Jr, MD, Professor of Surgery and Pediatrics, Emeritus Head, Division of Pediatric Surgery, Medical University of South Carolina
H Biemann Othersen Jr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Association for the Surgery of Trauma, American Burn Association, American Cancer Society, American College of Surgeons, American Medical Association, American Pediatric Surgical Association, American Society for Parenteral and Enteral Nutrition, American Surgical Association, American Thoracic Society, British Association of Paediatric Surgeons, Society for Surgery of the Alimentary Tract, Society of Critical Care Medicine, South Carolina Medical Association, Southeastern Surgical Congress, Southern Medical Association, Southern Society for Pediatric Research, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

Chief Editor

Maureen Strafford, MD, Arnold P Gold Foundation Associate Professor, Departments of Anesthesiology and Pediatrics, Tufts University and Tufts-New England Medical Center
Maureen Strafford, MD is a member of the following medical societies: American Medical Women's Association, American Pain Society, American Society of Anesthesiologists, International Anesthesia Research Society, Society for Education in Anesthesia, Society for Pediatric Anesthesia, and Society of Cardiovascular Anesthesiologists
Disclosure: Nothing to disclose.

 
 
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