Girls going through puberty but having missed periods, or having abdominal pain, watch out for ‘vaginal aplasia’

On April 14, a source from Tam Anh Hospital (HCMC) said that the doctors of the disease have just created a “tunnel” to drain 500 ml of thick menstrual blood that has been stagnant for a long time in the uterus and vagina, pumping out the entire blood bag for an 11-year-old girl going through puberty.

Doctor Nguyen Ba My Nhi checked health for pediatric patients after surgery bvcc

60 minutes to create a vaginal tube for a pediatric patient

The girl’s mother said that from November 2021, she noticed that the baby started to have abdominal pain below the navel, but did not see it period. During 5 months of abdominal pain but no period, every month the baby has abdominal pain for about 7-10 days, the abdomen is heavy, feeling tight. Recently, the baby is in more pain, can’t eat or sleep normally, and has lost 5 – 6 kg of weight.

Accompanied by the child’s difficulty in defecation, the study was interrupted many times due to the abdominal pain becoming more and more continuous and aggravated. Worried about her child, the family took her to Tam Anh Hospital in Ho Chi Minh City for a gynecological examination.

Through the description of the baby’s mother as well as observing the signs on the body, the doctors determined that this is a case where the girl has entered puberty but has not yet seen her period.

From the results of gynecological ultrasound suggested, the baby was assigned magnetic resonance imaging (MRI) pelvic floor. The results showed that the reproductive organs, ovaries, and uterus were normal, but the vagina was aplastic mid-section. The child’s vaginal canal was not empty as usual, but was completely “solid” about 5 cm in the middle third. Vaginal plexus is solidified, with negligible thickness, anteriorly attached to the bladder, posteriorly attached to the rectum.

“The condition of the vagina is thick, causing the uterus to have menstrual blood stasis, which causes a large stretch from the uterus to the upper third of the vagina and large-scale pressure on the rectum, causing the baby to defecate a lot but not walking, quality of life is seriously affected. We determined the baby had birth defects of the genital tract there is not a long vagina, also known as vaginal aplasia,” said Dr. Nguyen Ba My Nhi, director of the Center for Obstetrics and Gynecology, Heart Disease in Ho Chi Minh City.

On April 6, the surgery lasted more than an hour under the guidance of ultrasound, the doctors used a technique to create an opening through the “condensed” vagina.

More than 500 ml of dark brown, thick, stagnant menstrual blood in the uterus and vagina for a long time has been drained out and the entire “bag” of blood is pumped continuously. A catheter is also inserted, retained to maintain the newly created “tunnel”. This “tunnel” maintenance catheter will be evaluated by the doctors and left for an appropriate amount of time before being removed.

After surgery, the child’s health was stable, the vaginal “tunnel” was working smoothly, and the menstrual blood was drained out normally. The patient was discharged healthy after 4 days of treatment.

Tam Anh Hospital in Ho Chi Minh City has also received an 11-year-old patient from Quang Nam with persistent abdominal pain that is getting worse and worse, causing physical exhaustion due to pain, poor appetite and difficulty in defecation. . Through examination, the doctor discovered that the baby had a rare vaginal aplasia birth defect.

Signs of vaginal aplasia

According to doctor My Nhi, vaginal aplasia is a birth defect in the female reproductive organs when the vagina does not have a completely hollow structure as usual, but is completely or partially “solid”.

“Normally, when girls enter puberty, there will be a milestone marking this period when menstruation occurs, menstrual blood flows through the hole. uterus pour directly into the lumen of the vaginal canal, and exit through the natural perforation of the hymen. However, in cases of vaginal aplasia like this girl, the vaginal canal is not present in the middle third, making it impossible for menstrual blood to flow through the vaginal canal to the outside as usual. Menstrual blood stagnates, pooling in the uterus because it can’t go anywhere, dilating the upper part of the vagina. The tension in the upper part of the uterus and vagina causes the patient to have increasing pain in the lower abdomen, unable to defecate as easily as usual.

If not detected early, the baby will be physically exhausted, psychologically traumatized due to a lot of pain. Menstrual blood stagnation, causing pressure on nearby organs, can lead to difficulty urinating. Patients also face the risk of reflux of menstrual blood into the abdomen through the two fallopian tubes, increasing the risk of tubal blood stasis, pelvic endometriosis.

Dr. Ngo Thi Binh Lua, Center for Obstetrics and Gynecology, Tam Anh Hospital, Ho Chi Minh City also added that there have been scientific studies showing that vaginal aplastic abnormalities appear right from the womb. pregnancy. This is because at some point during the first 20 weeks of pregnancy, the Mullerian tubes don’t develop normally. A baby girl is born with normal development, enough external genitals such as big lips and small lips, but inside the uterus, the vagina may only develop partially or not at all.

Doctor Ngo Thi Binh Lua also added that, at present, some causes of delayed menstruation and amenorrhea such as ovarian failure, polycystic ovary syndrome, delayed puberty, etc. may be related to hormonal abnormalities. female, genetic, chromosomal abnormalities, or congenital anomalies of the genital organs such as absence of a uterus, a pediatric uterus, or hymen occlusion, vaginal aplasia…