VAGINAL MALDEVELOPMENT

Common variations of vaginal maldevelopments:

♦ Agenesis of vagina

♦ Failure of vertical fusion

♦ Failure of lateral fusion.

Etiological factors for Müllerian malformations are not clearly understood.

The probable causes are: polygenic, multifactorial, teratogens, or environmental.

PATHOLOGY OF MULLERIAN MALFORMATION: It may be due to failure of formation of the vaginal plate or due to its failure of canalization or cavitation. Vertical fusion defects result in failure of fusion of the Müllerian system with urogenital sinus. It may also be due to incomplete or segmental canalization of the vagina.

Disorders of lateral fusion are also due to failure of the two Mulerian ducts to unite. This results in double uterovaginal canals. Such malformation may be obstructive or nonobstructive.

Transverse vaginal septa are due to faulty fusion or canalization of the urogenital sinus and the Mullerian ducts. About 45% occur in the upper vagina, 40% in mid vagina and 15% in the lower vagina. Septum located in the lower vagina is often complete and the signs and symptoms are similar to that of imperforate

hymen. Ultrasonography is a useful investigation to detect hematometra, hematocolpos, and also urinary tract malformations. The principles of surgical treatment are the same. Septum in the upper vagina is often perforated. Incision of a complete (imperforate)

septum becomes easy when the upper vagina is distended. This reduces the risk of injury to adjacent organs. Otherwise abdominovaginal approach is made.

Longitudinal septum of the vagina may be present when the distal parts of the Mullerian ducts fail to fuse (fusion failure). It may be associated with double uterus and double cervix. It may be asymptomatic and needs no treatment. But it may cause dyspareunia or may obstruct delivery. In such circumstances, the septum is to be excised. Results of surgery are good in terms of achieving pregnancy.

ROLE OF HOMOEOPATHIC MEDICINES IN MANAGING VAGINAL COMPLICATIONS: -

Homeopathic medicine is an excellent way of managing any vaginal complications. As it has negligible side effects it is safe to use for both children and adults.

Homeopathic treatment also prevents it from recurring by extracting the root cause and boosting body's immunity.

The commonly used medicines are: -

• Sepia
• Calcarea carb
• Pulsatilla
• Thuja
• Nitric acid
• Monilia albicans
• Helonias etc.