Female genital anomalies are developmental defects of female reproductive system. These problems develop very early in intrauterine life around 6 to 12 weeks of pregnancy. It can involve any or all of the organs of female reproductive system namely uterus, cervix, vagina, hymen or labia. Many times, these problems are associated with those of the kidneys and ureters.
Female genital anomalies are classified according to the organs involved. Those of the uterus include the absent uterus, the unicornuate uterus, the bicornuate uterus, the septate uterus, and the double uterus. Anomalies of the cervix include an absent cervix and duplication of the cervix. Vulval anomalies include labial hypoplasia and labial hypertrophy. Anomalies of the hymen are septate hymen, microperforate hymen, and imperforate hymen. The anomalies of the vagina can be transverse vaginal septum, complete vertical vaginal septum, or vaginal agenesis (absent vagina).
The cause of female genital anomalies lies within the intrauterine life of a fetus. During development, the female genital system develops in the embryo from a structure called paramesonephric ducts or Mullerian ducts. These are paired structures. Failure to fuse duplication or any combination of problems that happen to Mullerian ducts are reflected as female genital anomalies. Diagnosis of most of these anomalies is delayed until puberty or sometimes after marriage also due to their concealed and nonobvious presentation.
Congenital anomalies of female genital tract affecting uterus and cervix are dealt by gynecologists. Plastic surgeon by virtue of his anatomical knowledge and excellent reconstructive surgical skills, plays vital role in correction of anomalies of vulva, vagina and hymen. Some atypical combination of anomalies warrant combined approach by a plastic surgeon and gynecologist. Cosmetic or aesthetic surgeries of female genital tract is another field mastered by plastic surgeon. Surgeries done by a plastic surgeon like vaginal tightening, labiaplasty, clitoroplasty, hymenoplasty, introitus tightening and combination of these help the patient to achieve their self esteem and confidence in personal life.
Cutis Hospital is a trustworthy and state of the art plastic surgery hospital run by an experienced and board-certified plastic surgeon. The highest level of safety standards are followed at Cutis Hospital along with the maintenance of strict confidentiality of the patient. Trained and experienced female staff at Curtis Hospital make the patient comfortable and lessen her anxiety. All the doubts and queries of the patient are answered with thorough explanations by our qualified plastic surgeon well before the surgery. Post-operative visits and all follow-up visits are attended by the operating plastic surgeon himself. Thus, female patient undergoing any sort of genital surgery at Cutis Hospital is treated with utmost dignity and confidentiality with excellent results and post-operative care.
Symptoms of female congenital genital anomaly are usually not apparent at birth. Many of these anomalies are diagnosed at the time of puberty. When patient has cyclical pain (every monthly) in lower abdomen without menstruation everytime, it points out to absent vagina since birth (vaginal agenesis). Imperforate hymen is presented as a painful bulge in the front portion of vagina with accumulation of menstrual fluid inside. Anomalies of uterus are manifested as the difficulty in having pregnancy or during investigations for repeated abortions. Exact incidence rate of these anomalies is not known. However, congenital anomalies of uterus are believed to affect upto 5 % of the population.
These anomalies develop during 6th to 12th week of intrauterine life of a fetus. The female genital tract develops from embryonic structure paramesonephric ducts or mullerian ducts. During the course of development of a fetus, paired mullerian ducts unite to form the uterus and remaining portion of female reproductive system. Various combination of problems of mullerian ducts produce different varieties of congenital anomalies of female genital tract. As the exact cause of mullerian duct problems is not known, it is not possible to prevent these anomalies. However, it is possible to diagnose some of these anomalies in fetal life by high definition ultrasound study of pregnancy.
Almost all congenital female genital tract anomalies are diagnosed at or after the puberty. Some are diagnosed as late as during the investigations for infertility or during pregnancy. Treatment starts after the confirmation of diagnosis by history, thorough physical examination and supportive investigations like ultrasonography and MRI. Treatment is customized for different types of anomalies. Problems like imperforate or microperforate hymen are treated by a minor surgery in which hymen is opened surgically so as to permit free flow of menstrual fluids. Problems like vaginal agenesis (complete absence of vagina) requires complex plastic surgical procedure of vaginal reconstruction and regular long term follow up to ensure the functional patency of reconstructed neovagina. Vaginal anomalies associated with anomalies of uterus or isolated uterine anomalies need help of an expert gynecologist.
The most commonly seen congenital vaginal anomalies are: transverse vaginal septum, complete or vertical vaginal septum and vaginal agenesis. Vaginal anomalies are diagnosed at the time of puberty when patient has difficulty in menstruation or doesn’t have menstruation at all.
The common congenital anomalies involving hymen are: imperforate hymen, microperforate hymen and septate hymen. As happen with vaginal anomalies, anomalies of hymen are also diagnosed during puberty.
Congenital anomalies of vulva include hypoplasia of labia or hypertrophy of labia. Vascular malformations of medial thigh and perineum can also extend and involve the labia. Congenital anomalies of cervix include; absent cervix or duplication of cervix. Most of the anomalies of cervix are associated with those of the uterus.
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