Obstructing malformations of the uterus and vagina.

Sixteen cases of obstructing malformations of the uterus and vagina treated at The Children's Hospital between 1970 and 1983 are discussed. These patients typically present with pain within 2 years of their menarche and a pelvic mass. Unilateral renal agenesis is the most common associated nongynecologic defect encountered (53%). The key to early diagnosis is a high index of suspicion when significant gynecologic symptoms develop in perimenarchal patients. A complete investigation should be carried out before the undertaking of corrective surgery, because a thorough understanding of the patient's anatomy is necessary for the determination of the type of operation that will optimally preserve reproductive and sexual function. The specific abnormalities encountered in this series are divided into three groups on the basis of the site(s) of obstruction. Recommendations for surgical treatment of each group are presented.