Neovagina creation using sigmoid colon in vaginal agenesis: a case report and review of literature

Manisha Albal, Prasad Y. Bansod, Mahendra Chauhan


Mullerian duct anomalies are rare and can present with abnormalities in upper vagina, cervix, uterus, and fallopian tubes. The exact incidence of cervicovaginal agenesis is unknown and there are very few cases recorded in the literature. Authors report a 12-year-old girl referred from gynaecologist with chronic cyclical abdominal pain with underdeveloped, geniatilia and developed secondary sexual characters. Radiological investigations showed hypoplastic cervix with hematometra and left hemato salpinx. A definitive repair with creation of a neovagina using a sigmoid colon segment was performed in a single stage. Many techniques are described for reconstruction of cervicovaginal canal. Use of colon in creation of a neovagina is described by authors. Here we report a case of complete vaginal agenesis presenting with Hematometra-Hematosalpinx where a neovagina was created using a segment of sigmoid colon. Single staged surgery for neovagina creation using segment of sigmoid colon offers a promising and safe alternative for cervicovaginal agenesis.



Cervicovaginal agenesis, Mullerian duct anomalies, Neovagina, Vaginal agenesis

Full Text:



Roberts CP, Rock JA. Surgical methods in the treatment of congenital anomalies of the uterine cervix. Curr Opin Obstetr Gynecol. 2011;23(4):251-7.

Kisku S, Varghese L, Kekre A, Sen S, Karl S, Mathai J, et al. Cervicovaginal atresia with hematometra: restoring menstrual and sexual function by utero-coloneovaginoplasty. Pediatr Surg Inter. 2014;30(10):1051-60.

Chandler T, Machan LS, Cooperberg PL, Harris AC, Chang SD. Müllerian duct anomalies: from diagnosis to intervention. Bri J Radiol. 2009;82(984):1034-42.

Templeman CL, Lam AM, Hertweck SP. Surgical management of vaginal agenesis. Obstetr Gynecol Surv. 1999;54(9):583-91.

Hendren WH, Atala A. Use of bowel for vaginal reconstruction. J Urol. 1994;152(2):752-5.

Tu D, Badalato G, Reiley EA, Hensle TW. Colovaginoplasty using the Yang-Monti modification. J Pediatr Urol. 2012;8(5):477-80.

Garcia-Roig M, Castellan M, Gonzalez J, Gorin MA, Cruz-Diaz O, Labbie A, et al. Sigmoid vaginoplasty with a modified single Monti tube: a pediatric case series. J Urol. 2014;191(5):1537-42.

Society TA. The American Fertility Society classifications of adnexal adhesions, distal tubal occlusion, tubal occlusion secondary to tubal ligation, tubal pregnancies, Müllerian anomalies and intrauterine adhesions. Fertil Steri. 1988;49(6):944-55.

Acién P, Acién MI. The history of female genital tract malformation classifications and proposal of an updated system. Human Reprod Update. 2011;17(5):693-705.

Oppelt P, Renner SP, Brucker S, Strissel PL, Strick R, Oppelt PG, et al. The VCUAM (Vagina Cervix Uterus Adnex–associated Malformation) Classification: a new classification for genital malformations. Fertil Steri. 2005;84(5):1493-7.

Bhagavath B, Greiner E, Griffiths KM, Winter T, Alur-Gupta S, Richardson C, et al. Uterine malformations: an update of diagnosis, management, and outcomes. Obstetr Gynecol Surv. 2017;72(6):377-92.

Fujimoto VY, Miller JH, Klein NA, Soules MR. Congenital cervical atresia: report of seven cases and review of the literature. Am J Obstetr Gynecol. 1997;177(6):1419-25.

Castrillon DH. Development and Maldevelopment of the Female Reproductive System. Gynecol Obstetr Pathol. 2019;1:1-40.

Acién P, Acién MI, Quereda F, Santoyo T. Cervicovaginal agenesis: spontaneous gestation at term after previous reimplantation of the uterine corpus in a neovagina: case report. Human Reprod. 2008;23(3):548-53.

Breech LL, Laufer MR. Müllerian anomalies. Obstetr Gynecol Clin North Am. 2009;36(1):47-68.

Karateke A, Haliloglu B, Parlak O, Cam C, Coksuer H. Intestinal vaginoplasty: seven years' experience of a tertiary center. Fertil Steri. 2010;94(6):2312-5.

Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R. Pediatric surgery E-book. Elsevier Health Sci; 2012.