Mullerian Agenesis

Mullerian agenesis, a rare congenital condition –also referred to as MRKHsyndrome or Müllerian aplasia, is caused by the embryologic growth failure of the müllerian duct. Most common presentations result in the congenital absence or underdevelopment  of the uterus or the vagina, or both. The vaginal canal is markedly shortened or absent. First-line treatment usually can be managed non-surgically with successive vaginal dilation.

The non-surgical process is an effective and safe method for the creation of a neo-vagina for patients with vaginal agenesis. In comparison with surgical methods, vaginal dilation has the advantage of low morbidity and no surgical scarring. This method uses progressively sized dilators to expand the vaginal opening.

If surgery is necessary to create a neo-vagina, post-operative dilation therapy is essential to help prevent significant skin graft contracture.  Dilators must be used intermittently until the woman is able to engage in regular sexual intercourse.

This condition is commonly discovered during puberty and the typical symptoms include:

  • Having a shortened vagina
  • Sexual pain
  • Absence of the cervix, uterus and/or vagina
  • Primary amenorreah (lack of menstrual periods)
  • Müllerian agenesis occurs in 1 out of every 4,000–10,000 women


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