Congenital absence of the vagina: diagnosis and plastic surgical reconstruction.

Congenital absence of the vagina was repaired in twenty patients; the longest follow-up was seventeen years. The surgical method is described, including the skin graft, the sculpted prosthesis, and the mechanic's waste bolus for retention. The patient must be oriented thoroughly before the operation. Even with an optimum surgical result, full cooperation and psychological preparation are necessary to gain a successful transformation. The phrase "psychiatry with a scalpel" is apt in these cases. Ideally, the operation is performed by a team of plastic surgeon and gynecologist. Meticulous planning and regard for detail are fundamental requirements.