Background: Vaginal agenesis is a congenital disorder characterized by partially or completely absent of the vagina. Vaginal agenesis is a rare condition with an incidence of 1 in 4,000 - 5,000 women. Ultrasound examination of vaginal agenesis shows the upper border of the vagina and abnormalities of the uterus clearly. Case Illustration: A 26-year-old woman complaining of never having menstruation accompanied by cyclic pain every month. The patient had undergone three operations to evacuate blood from the vagina. After the third operation, the patient complaining of feces from the vagina. From the examination, we found that the vaginal length was ± 3 cm with no portio palpable, and discontinuity in the posterior vaginal wall until it penetrated the anus and the uterus was larger. We performed neovaginal reconstruction, uterovaginal anastomosis, and rectovaginal fistula repair. Conclusion: Vaginal agenesis is a rare congenital abnormality. The main goals of surgery on young women are to reduce complaints, restore the normal anatomical structures, menstrual function, sexuality, and maintain the reproductive ability.
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