Vaginal reconstruction for distal vaginal atresia without anorectal malformation: is the approach different?

Retrospective study of eight patients with distal vaginal atresia without anorectal malformation shows varied presentation (neonatal hydrocolpos vs. post-pubertal hematometrocolpos) and surgical approaches. Reconstruction required 1-7 operations per patient, using perineal or abdomino-perineal techniques; one case needed colonic vaginal replacement. Authors recommend drainage with menstrual suppression followed by planned reconstruction as optimal strategy.