A rare case of absence of menstruation in a 22-year-old woman was recently treated by city doctors by reconstructing her vagina through unique robotic surgery. An MRI scan of the woman had revealed that she was suffering from a rare condition called Mayer-Rokitansky-KüsterHauser (MRKH) syndrome.

MRKH syndrome is a condition that causes the vagina and uterus to be underdeveloped or absent, although external genitalia is normal. Following this diagnosis, doctors performed robotic-assisted sigmoid vaginoplasty, an aspect of ‘feminising genitoplasty’, which is a reconstruction of human genitals.

Vaginal atresia is a congenital anomaly in which the vagina is either closed or absent, while the uterus is present. In both the above conditions, parents and the medical community don’t have a diagnosis until adolescence when the absence of menstruation becomes a wake-up call.

Dr Sanjay Pandey from Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute observed that often the first noticeable sign of MRKH syndrome, such as menstruation not beginning by age 16 (primary amenorrhea), is usually ignored as the presentation is delayed. Dr Pandey is the head of andrology and reconstructive urology, consultant of robotic urology and gender reassignment surgery at the hospital. He said vaginal atresia presents with painful lower abdomen as a symptom of monthly menstruation with no outlet as blood collects in the uterus.