Vaginal agenesis does not always have to be treated right away. Many girls and young women wait until their late teens or early twenties to begin treatment. At this time, they are usually more mature and better able to handle it.
Vaginal dilation is a nonsurgical option. It involves pressing a plastic tube called a vaginal dilator against the area where the vagina should be. Usually, this is done for about 20-30 minutes a day. Over time, larger dilators are used until a complete vagina is formed.
This method can be quite successful, but the patient must be motivated and use the dilators consistently and correctly. It normally takes six to twelve months to create a vagina, but with more frequent dilation, it may take less time.
Vaginal reconstruction uses tissue from another part of the body to create a vagina. This tissue might be taken from the inside of the cheek, the large bowel, or the buttock. After making an incision where the vagina should be, the surgeon inserts a mold of the new vagina with the tissue attached. The mold is later removed.
Recovery time after surgery varies. Most girls need to keep dilators in the new vagina continuously for several weeks or months, removing them only for urination or bowel movements.
The Vecchietti procedure, performed laparoscopically, uses a traction device to create a vagina. The traction device is placed outside the body, on the abdomen, attached to the skin. An olive-sized plastic bead is placed where the vagina should start. The bead is attached to a string, which is threaded internally through the abdomen, then brought outside and attached to the traction device,. By turning a crank, the patient gradually pulls the bead up for the next seven to ten days. This creates the vagina. The bead, string, and traction device are later removed.
Coping with vaginal agenesis and its treatment can be difficult for girls and their families. Counseling and peer support groups can be helpful.