title: Pitfalls in diagnosis and management of distal vaginal agenesis: 10-year experience at a single centre.
abstract: OBJECTIVE
  To discuss common pitfalls in diagnosis and management of distal vaginal agenesis, and summarize 10 years of experience among 11 patients using an interposition full-thickness graft and fibrin glue.
  
  
  METHODS
  Eleven patients with distal vaginal agenesis were evaluated and managed with an interposition full-thickness graft to bridge the gap between the upper vagina and the introitus. Associated renal abnormalities and complications including infection, total lack of skin graft take, stress urinary incontinence, partial graft loss, vaginal stricture and graft uptake were all investigated.
  
  
  RESULTS
  The mean age of the patients was 12.91 (standard deviation 1.22) years. All patients had primary amenorrhoea, cryptomenorrhea, and cyclical or constant pelvic pain. None of the patients had associated urological abnormalities, and there were no cases of infection, total lack of skin graft take, stress urinary incontinence, partial graft loss or vaginal stricture. Graft uptake was 100% in 10 of the 11 patients. Four patients have subsequently married and report a satisfactory sex life.
  
  
  CONCLUSIONS
  Accurate diagnosis of distal vaginal agenesis and careful pre-operative set-up, including evaluation of associated anomalies, bowel preparation, available vaginal stents and a multidisciplinary approach for the potential need for grafts, may be key to success.
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine, Gaziantep University, Gaziantep, Turkey. metegurolugur@hotmail.com
authors.forename: M G
authors.initials: MG
authors.lastname: Ugur
authors.forename: O
authors.initials: O
authors.lastname: Balat
authors.forename: E
authors.initials: E
authors.lastname: Ozturk
authors.forename: M
authors.initials: M
authors.lastname: Bekerecioglu
authors.forename: E
authors.initials: E
authors.lastname: Dikensoy
mesh_terms: D000293:Adolescent; D000568:Amenorrhea / Q000209:etiology; D002648:Child; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006399:Hematocolpos / Q000601:surgery; D006801:Humans; D016038:Skin Transplantation / Q000379:methods; D015607:Stents; D014463:Ultrasonography; D014621:Vagina / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery
chemical_list: D015718:Fibrin Tissue Adhesive