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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Vagina

Illustrated Encyclopedia of Human Anatomic Variation: Opus IV: Organ Systems: Female Genital System

Vagina

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed


The most important variations are related to defective development and imperfect fusion of the component müllerian ducts, which are often associated with anomalies of the uterus. When these ducts fail to reach the urogenital sinus, the vagina (and often the uterus) may be absent.

Vaginal agenesis was first described by Realdus Columbus in 1572. Duplication, more or less complete, follows persistence of separate or imperfectly fused müllerian ducts. The doubling may not extend throughout the length of the vagina, but may be represented by an imperfect and partial septum, isolated bands, or a twin hymen.

Unequal development of the müllerian ducts accounts for the marked asymmetry occasionaly seen, notably in double vaginae, in which one canal may be very rudimentary, end blindly, or be essentially normal but doubled throughout.

A doubled vagina may be associated with a single uterus, although this condition is usually found in cases of doubled or bipartite uteri. In some instances, the cervices are doubled.

The vagina may be markedly foreshortened.

Reports of the vagina opening into the urethra, bladder, or rectum, or onto the abdominal wall in adults are very rare.

Pregnancy in a case of an anovaginal orifice (i.e., lack of a normal external vaginal opening) has been reported.

Image 45 Double Vagina

Image 46 Double Vagina and Double Uterus

Image 67 Doubled Vagina and Uterus

Image 107 Doubled Uterus and Vagina

Image 108 Double Vagina


References

Almeida, A. de. (1956) La macronymphie chez les femmes indigènes de l'Angola. Assoc. Anatomistes Comptes Rendus 43:131-150.

Bastien, -. et -. LeGendre. (1859) Absence complète de l'utérus de trompes, du vagin et du rein droit. Soc. Biol. Comptes Rendus des Séances et Mémoires 11:96-99.

Bryan, A.L., Nigro, J.A. and V.S. Counseller. (1949) One hundred cases of congenital absence of the vagina. Surg., Gynecol Obstet. 88:79-86.

Bulmer, D. (1957) The development of the human vagina. J. Anat. 91:490-509.

Burt, S.S. (1877) Case of a single uterus with double vagina. New York Med. J. 25:177-180.

Capraro, V.J. and M.B. Gallego (1976) Vaginal agenesis. Am. J. Obstet. Gynecol. 124:98-107.

Chantreuil, -. (1866) Closion transversale du vagin. Bulletins et Mem. de la Société Anatomique de Paris XLI(2):33-35.

Cordier, G. and -. Malinas. (1951) Quelques précisions sur l'absence congénitale du vagin (à propos de dix cas cas personnels). Assoc. Anatomistes Comptes Rendus 38:285-293.

Currie, D.W. (1888) Amenorrhae from imperforate hymen. Brit. Med. J. 2:876.

DePaul, -. (1853) Deux observations tératologiques (avec deux planches), portant sur des examples remarquables de vices de conformation, l'un de utérus et du vagin, l'autre des organes genito-urinaires. Soc. Biol. Comptes Rendus des Séances et Mémoires. 5:271-284.

Depaul, -. (1853) Organes genitaux d'une femme; Vagin double; utérus double. Bulletins et Mem. de la Société Anatomique de Paris XXVIII(12):397-399.

DePaul, M. (1857) Imperforation congénitale du vagin; dilation considérable de ce conduit avec accumulation de liquide dans son intérieur; estomac situé àdroite. Soc. Biol. Comptes Rendus des Séances et Mémoires. 9:46-48.

Després, -. (1870) Absence de vagin. Bulletins et Mem. de la Société Anatomique de Paris XLV(6):380-381.

Duncan, J.M. (1868) On cases of vagina duplex et uterus simplex and of saccated uterus. J. Anat. Physiol. 1:269-274.

Féré, Ch. (1878) Utérus et vagin doubles. Bulletins et Mem. de la Société Anatomique de Paris LIII(5):309-312.

Gemmel, A.A., Woolfenden, H.F. and J.E. Frazer. (1938) An unusual congenital abnormality of the vagina. J. Obstet. Gynecol. Brit. Empire. 45:663-666.

Girard, -. (1870) Absence complète de vagin avec rudiments de l'utérus. Bulletins et Mem. de la Société Anatomique de Paris XLV(6):378-380.

Godard, -. (1855) Femme ayant deux vagins séparés par une cloison verticale complete et deux cols utérins de forme et de volume différents. Bulletins et Mem. de la Société Anatomique de Paris XXX(9,10):431-435.

Harmon, N.B. (1898) Anomalous female urogenital organs. J. Anat. Physiol. 32:211-215.

Henry, -. (1854) Vagin divisé, par une cloison verticle. Bulletins et Mem. de la Société Anatomique de Paris XXIX(4):107.

Hepburn, D. (1891) Malformation of the female organs of generation - vagina duplex et uterus duplex - associated with the displacement of the right kidney. J. Anat. Physiol. 25:24-30.

Hirne, -. (1873) Utérus et vagin doubles chez un femme accouchée quelque temps auparavant. Bulletins et Mem. de la Société Anatomique de Paris XLVIII(7):509-510.

Hricak, H, Chang, Y.C.F. and S. Thurnher. (1988) Vagina: Evaluation by M.R. imaging. Part 1. Normal anatomy and congenital anomalies. Radiology 169:169-174.

Kanter, A.E. (193 5) Congenital absence of the vagina: A simplified operation with the report of one case. Am. J. Surg. 30:314-316.

Killinger, R.R. and B.H. McEuen. (1946) Double uterus and double vagina: Identical doubles demonstrated by colophysterosalpingography. Am. J. Obstet. Gynecol. 51:121-124.

Krysinski, S. (1888) Eine seltene Hymenanomalie. Arch. Pathol. Anat. Physiol. Klin. Med. 111:386.

Kuligowska, S. (1931) La longueur du vagin et son rapport a la stature de la femme. Assoc. Anatomistes Comptes Rendus 26:330-333.

Kuligowska, S. (1931) Dimensions des grandes et des petites lèvres. Assoc. Anatomistes Comptes Rendus 26:334-339.

Latarjet, A. (1931) Testut's Traite d'Anatomie Humain, Tome V, G. Doin & Cie, Eds., Paris.

Lloyd, F.A. and D. Bonnett. (1950) Müllerian duct cysts. J. Urol. 64:777-781.

Maès, E. (1923) Development anormal des seins. Malformation des organes genitaux externes. Aspect feminim chez un nègre adulte. Bull. et Mém. de la Soc. d'Anthrop. de Paris. 4:68-69.

Ollivier, A. (1870) Note sur un cas d'utérus et de vagin doubles. Soc. Biol. Comptes Rendus des Séances et Mémoires 22:35-38.

Porak, -. (1876) Vagin et uterus dobules. Bulletins et Mem. de la Société Anatomique de Paris LI(6):454-456.

Reel, P.J. (1943) Congenital absence of the vagina. Ohio State Med. J. 39:1117-1119.

Rendu, -. (1869) Vagin et utérus bifide. Bulletins et Mem. de la Société Anatomique de Paris XLIV(12):541-542.

Roussel, -. (1843) Duplicate du vagin. Bulletins et Mem. de la Société Anatomique de Paris XVIII(10):292.

Vainright, Jr., J.R., Fulp, Jr., C.J. and M.L. Schiebler. (1988) MR Imaging of vaginal agenesis with hematocolops. J. Computer Assist. Tomogr. 12(5):891-893.

Verneuil, -. (1856) Vice de conformation du vagin, Brièveté rétrécissement problement congénital de ce conduit. Soc. Biol. Comptes Rendus des Séances et Mémoires 8:201-202.

Voisin, -. (1856) Rétention menstruelle causée par imperforation du vagin. Utérus bifide. Bulletins et Mem. de la Société Anatomique de Paris XXXI(5):145-146.

Warren, J.M. (1857) Complete absence of vagina and uterus. Boston Med. Surg. J. 56:297.

Weintrob, M. (1944) Abnormalities of the female genitalia. J. Int. Coll. Surgeons 7:381-396.

Wells, B.H. (1900) The clinical significance of development duplications of the uterus and vagina. Am. J. Obstet. 41:317-365.

Word, B. (1951) The construction of an artificial vagina, with ten year follow up studies. South. Med. J. 44:375-382.

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