Vaginal Absence


Some women are born with vaginal absence deformities and can often experience unforeseen physical and emotional challenges. Some women may have vaginal abnormalities from trauma or prior surgery. Physicians at Houston Methodist provide care with integrity and accountability, so our patients can recover quickly, with minimal discomfort. We appreciate the challenge of congenital absence of the vagina in patients and understand their desire to live full, active lives. We make it our goal to give women that chance.

MRKH Syndrome (Mayer-Rokitansky-Küster-Hauser Syndrome)
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare congenital disease that affects roughly 1 out of every 4,500 women. MRKH syndrome is characterized by an absence of the vagina and uterus, which is usually not discovered until the patient has reached puberty. The condition is not recognized early in life because patients have normal female external genitalia and normal breast and pubic hair development, as well as normal ovaries and ovarian hormone production.

Symptoms normally begin to show when menstruation does not begin by age 16 (primary amenorrhea). Although women with this condition are usually unable to carry a pregnancy, they may be able to have children with the help of assisted reproduction.

Women with MRKH syndrome may also have abnormalities in other parts of the body. The kidneys may be abnormally formed or positioned, or one kidney may fail to develop (unilateral renal agenesis). Affected individuals commonly develop skeletal abnormalities, particularly of the spinal bones (vertebrae). Patients with MRKH syndrome may also have hearing loss or heart defects.

Treating Vaginal Absence Deformities
Treatment options are available to help patients live with or to correct MRKH syndrome abnormalities. Though treatment options are primarily surgical, talk to your doctor about which options might be best for your lifestyle and quality of life.

  • A vagina can be created without surgery, using a dilator that expands and stretches the existing vagina over time using intermittent pressure.
  • A vaginoplasty may be performed, using a skin graft from another part of the body.

Vaginal Reconstruction
The goals of reconstructive pelvic surgery are to provide symptom relief, return the organs to their normal anatomic position if possible and restore normal organ function. Vaginal reconstruction is performed for problems such as pelvic organ prolapse or for scarring that may contribute to pain with sexual intercourse. With modern techniques and new graft materials, restorative pelvic surgery results in much better long-term success than with traditional techniques used just a few years ago. For complex wounds and pelvic problems, such as genitourinary or rectovaginal fistulae, a muscle flap can be used in the vagina to help wound healing.
Vaginal reconstruction can accomplish the following for you:
  • Cover or close the wound and separate the outside environment from the pelvic cavity
  • Reconstruct an organ, which can restore a woman’s sexual function and repair a delicate area of the body to an acceptable appearance
  • Assist in physiological and psychological recovery through sexual therapy
  • Restore sensation

Vulvar Reconstruction
The vulva is the entire external part of the female genitalia. The vulva consists of the outer and inner lips of the vagina (labia majora and labia minora). The perineum is the area between the bottom of the vulva and the anus.

Conditions that may require vulvar reconstruction are carcinoma in situ and cancer of the vulva. Because these conditions may cause unsightly defects in the external genitalia, methods of vulvar reconstruction provide immediate anatomical restoration. Another benefit of the procedure is proper healing at the tumor removal site.

These issues can greatly impact your quality of life, but they can be resolved. Your first step is to talk with one of our specialists.

Houston Methodist combines the expertise of urogynecologists — specialty physicians trained in the areas of urology and gynecology — as well as traditional gynecologists and colorectal surgeons to provide the most advanced care available for women and men with problems related to the lower urinary tract and the pelvic floor. The Center for Restorative Pelvic Medicine at Houston Methodist Hospital is the first of its kind in the Greater Houston area and is one of the few centers in the country that offers a single-center location for the diagnosis and treatment of complex pelvic-floor disorders.


Our physicians at Houston Methodist specialize in treating vaginal absence deformities at the following convenient locations: