[Congenital absence of the vagina. Anatomo-clinical study and therapeutic results apropos of 93 cases].

Congenital absence of the vagina is the second cause of primary amenorrhea. Among 93 cases treated between 1956 and 1981, vulvar morphology was normal in only 37%. Partial bilateral absence of uterus was more frequent than total or than major asymmetric absence. 8 patients had a functional uterus. Ovaries were nearly always normal except in 5 cases of male hermaphroditism. Genetic abnormalities were exceptional. 30% patients had congenital abnormalities of urinary tract, especially when the uterus malformation was important and/or asymmetric. Unilateral renal absence was most common abnormality. 56 patients were treated by recto-vesical cleavage, without skin grafts with more than 90% anatomical and functional good results. 21 patients had been treated by Frank non operative method. Ileal and sigmoid plasties were performed five times. In absence of functional uterus, treatment of congenital absence of vagina must be simple. Frank method's when vulvar is normal; Recto-vesical cleavage, on the others cases.