Vaginal agenesis.

Development of the normal vagina is dependent on the mesonephric duct, paramesonephric duct, and urogenital sinus. A mesonephric anomaly may account for vaginal agenesis, and this defect also explains the associated genitourinary abnormalities. Patients usually present with primary amenorrhea and have a normal female phenotype with normal karyotype and hormonal function. Vaginal reconstruction has most commonly been carried out by use of a split-thickness skim graft with successful long-term results.