Editing Vagina (section)

===Anomalies and other health issues===
{{See also|Vaginal atresia}}
[[File:Vagina US.png|right|thumb|alt=Ultrasonograph depicting urinary bladder at the top, above the uterus to its bottom-left and vagina to its bottom-right|An [[Medical ultrasonography|ultrasound]] showing the [[urinary bladder]] (1), uterus (2), and vagina (3)]]
[[Vaginal anomalies]] are defects that result in an abnormal or absent vagina.<ref name= emed2>{{Cite web |date=April 13, 2016 |author=Lawrence S Amesse |title=Mullerian Duct Anomalies: Overview, Incidence and Prevalence, Embryology |url=https://emedicine.medscape.com/article/273534-overview#a4 |access-date=January 31, 2018 |archive-url=https://web.archive.org/web/20180120070642/https://emedicine.medscape.com/article/273534-overview |archive-date=2018-01-20 |url-status=live}}</ref><ref>{{Cite web|url=http://www.merckmanuals.com/professional/pediatrics/congenital-renal-and-genitourinary-anomalies/vaginal-anomalies|title=Vaginal Anomalies-Pediatrics-Merck Manuals Professional Edition|access-date=January 6, 2018|archive-date=January 29, 2019|archive-url=https://web.archive.org/web/20190129072510/https://www.merckmanuals.com/professional/pediatrics/congenital-renal-and-genitourinary-anomalies/vaginal-anomalies|url-status=live}}</ref> The most common obstructive vaginal anomaly is an [[imperforate hymen]], a condition in which the hymen obstructs menstrual flow or other vaginal secretions.<ref name="Pfeifer">{{cite book|vauthors=Pfeifer SM|title=Congenital Müllerian Anomalies: Diagnosis and Management|publisher=[[Springer Publishers|Springer]]|isbn=978-3-319-27231-3|year=2016|pages=43–45|url=https://books.google.com/books?id=7TyVDAAAQBAJ&pg=PA43|access-date=January 31, 2018|archive-date=July 3, 2019|archive-url=https://web.archive.org/web/20190703215939/https://books.google.com/books?id=7TyVDAAAQBAJ&pg=PA43|url-status=live}}</ref><ref name="Zhu">{{cite book|vauthors=Zhu L, Wong F, Lang J|title=Atlas of Surgical Correction of Female Genital Malformation|publisher=[[Springer Publishers|Springer]]|isbn=978-94-017-7246-4|year=2015|page=18|url=https://books.google.com/books?id=-l54CgAAQBAJ&pg=PA18|access-date=April 2, 2018|archive-date=July 3, 2019|archive-url=https://web.archive.org/web/20190703211243/https://books.google.com/books?id=-l54CgAAQBAJ&pg=PA18|url-status=live}}</ref> Another vaginal anomaly is a [[transverse vaginal septum]], which partially or completely blocks the vaginal canal.<ref name="Pfeifer"/> The precise cause of an obstruction must be determined before it is repaired, since corrective surgery differs depending on the cause.<ref name="Coran">{{cite book|vauthors=Coran AG, Caldamone A, Adzick NS, Krummel TM, Laberge JM, Shamberger R|title=Pediatric Surgery|publisher=[[Elsevier Health Sciences]]|isbn=978-0-323-09161-9|year=2012|page=1599|url=https://books.google.com/books?id=QpabASTwF_sC&pg=PA1599|access-date=March 4, 2015|archive-date=May 15, 2015|archive-url=https://web.archive.org/web/20150515033701/https://books.google.com/books?id=QpabASTwF_sC&pg=PA1599|url-status=live}}</ref> In some cases, such as isolated [[vaginal agenesis]], the external genitalia may appear normal.<ref name="Nucci">{{cite book|vauthors=Nucci MR, Oliva E|title=Gynecologic Pathology E-Book: A Volume in the Series: Foundations in Diagnostic Pathology|publisher=[[Elsevier Health Sciences]]|isbn=978-94-017-7246-4|year=2015|page=77|url=https://books.google.com/books?id=7fbLXoJy9MUC&pg=PA77|access-date=April 2, 2018|archive-date=July 3, 2019|archive-url=https://web.archive.org/web/20190703211232/https://books.google.com/books?id=7fbLXoJy9MUC&pg=PA77|url-status=live}}</ref>

Abnormal openings known as [[fistula]]s can cause [[urine]] or [[Human feces|feces]] to enter the vagina, resulting in incontinence.<ref name="Bodner-Adler">{{cite journal|date=February 22, 2017 |title=Management of vesicovaginal fistulas (VVFs) in women following benign gynaecologic surgery: A systematic review and meta-analysis|journal=PLOS ONE|volume=12|issue=2|pages=e0171554|doi=10.1371/journal.pone.0171554|pmid=28225769|pmc=5321457|vauthors=Bodner-Adler B, Hanzal E, Pablik E, Koelbl H, Bodner K|bibcode=2017PLoSO..1271554B|doi-access=free}}</ref><ref name="Köckerling">{{cite journal|date=2015|title=Treatment of Fistula-In-Ano with Fistula Plug - a Review Under Special Consideration of the Technique|journal=Frontiers in Surgery|volume=2|pages=55|doi=10.3389/fsurg.2015.00055|pmid=26528482|pmc=4607815|vauthors=Köckerling F, Alam NN, Narang SK, Daniels IR, Smart NJ|doi-access=free}}</ref> The vagina is susceptible to fistula formation because of its proximity to the [[Urinary tract|urinary]] and [[Gastrointestinal tract|gastrointestinal]] tracts.<ref name="Priyadarshi">{{cite journal|date=June 2016|title=Genitourinary Fistula: An Indian Perspective|journal=Journal of Obstetrics and Gynaecology of India|volume=66|issue=3|pages=180–4|doi=10.1007/s13224-015-0672-2|pmc=4870662|pmid=27298528|vauthors=Priyadarshi V, Singh JP, Bera MK, Kundu AK, Pal DK}}</ref> Specific causes are manifold and include obstructed labor, hysterectomy, [[malignancy]], radiation, [[episiotomy]], and bowel disorders.<ref name="Raassen">{{cite journal|date=December 2014|title=Iatrogenic genitourinary fistula: an 18-year retrospective review of 805 injuries|journal=International Urogynecology Journal|language=en|volume=25|issue=12|pages=1699–706|doi=10.1007/s00192-014-2445-3|pmid=25062654|vauthors=Raassen TJ, Ngongo CJ, Mahendeka MM|pmc=4234894}}</ref><ref name="Maslekar">{{cite journal|date=December 2012|title=The challenge of pouch-vaginal fistulas: a systematic review|journal=Techniques in Coloproctology|volume=16|issue=6|pages=405–14|doi=10.1007/s10151-012-0885-7|pmid=22956207|vauthors=Maslekar S, Sagar PM, Harji D, Bruce C, Griffiths B|s2cid=22813363}}</ref> A small number of vaginal fistulas are [[congenital]].<ref name="Fernandez">{{cite journal|date=September 2015|title=Congenital recto-vaginal fistula associated with a normal anus (type H fistula) and rectal atresia in a patient. Report of a case and a brief review of the literature |journal=Investigacion Clinica|volume=56|issue=3|pages=301–7|pmid=26710545|vauthors=Fernández Fernández JÁ, Parodi Hueck L}}</ref> Various surgical methods are employed to repair fistulas.<ref name="Tenggardjaja">{{cite journal | vauthors = Tenggardjaja CF, Goldman HB | s2cid = 27012043 | title = Advances in minimally invasive repair of vesicovaginal fistulas | language = en | journal = Current Urology Reports | volume = 14 | issue = 3 | pages = 253–61 | date = June 2013 | pmid = 23475747 | doi = 10.1007/s11934-013-0316-y }}</ref><ref name="Bodner-Adler" /> Untreated, fistulas can result in significant [[disability]] and have a profound impact on [[quality of life]].<ref name="Bodner-Adler"/>

[[Vaginal evisceration]] is a serious complication of a [[vaginal hysterectomy]] and occurs when the [[vaginal cuff]] [[Wound dehiscence|ruptures]], allowing the [[small intestine]] to protrude from the vagina.<ref name="Hoffman" /><ref name="Cronin">{{Cite journal|date=April 2012|title=Vaginal cuff dehiscence: Risk factors and management|journal=American Journal of Obstetrics and Gynecology|volume=206|issue=4|pages=284–288|doi=10.1016/j.ajog.2011.08.026|issn=0002-9378|pmc=3319233|pmid=21974989|doi-access=free|vauthors=Cronin B, Sung V, Matteson K}}</ref>

[[Cyst]]s may also affect the vagina. Various types of [[vaginal cysts]] can develop on the surface of the vaginal epithelium or in deeper layers of the vagina and can grow to be as large as 7&nbsp;cm.<ref name=lall>{{Cite journal |vauthors=Lallar M, Nandal R, Sharma D, Shastri S |date=January 20, 2015 |title=Large posterior vaginal cyst in pregnancy|journal=BMJ Case Reports|volume=2015|pages=bcr2014208874 |doi=10.1136/bcr-2014-208874|issn=1757-790X|pmc=4307045|pmid=25604504}}</ref><ref>{{Cite web|url=https://medlineplus.gov/ency/article/001509.htm|title=Vaginal cysts: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|language=en|access-date=February 17, 2018|archive-date=November 2, 2020|archive-url=https://web.archive.org/web/20201102003330/https://medlineplus.gov/ency/article/001509.htm|url-status=live}}</ref> Often, they are an incidental finding during a routine pelvic examination.<ref name=":0">{{Cite journal |vauthors=Elsayes KM, Narra VR, Dillman JR, Velcheti V, Hameed O, Tongdee R, Menias CO |s2cid=31444644|date=October 2007|title=Vaginal masses: magnetic resonance imaging features with pathologic correlation|journal=Acta Radiologica  |volume=48|issue=8|pages=921–933|doi=10.1080/02841850701552926|issn=1600-0455|pmid=17924224}}</ref> Vaginal cysts can mimic other structures that protrude from the vagina such as a rectocele and cystocele.<ref name=lall/> Cysts that can be present include [[Müllerian cyst]]s, [[Gartner's duct cyst]]s, and [[epidermoid cyst]]s.<ref name=":4">{{Cite book|url=https://books.google.com/books?id=TYlZsGdwqrQC&q=Vaginal+cyst&pg=PA220|title=Gynecology: Integrating Conventional, Complementary, and Natural Alternative Therapy|vauthors=Ostrzenski A|date=2002|publisher=Lippincott Williams & Wilkins|isbn=978-0-7817-2761-7|language=en|access-date=October 19, 2020|archive-date=March 10, 2021|archive-url=https://web.archive.org/web/20210310000717/https://books.google.com/books?id=TYlZsGdwqrQC&q=Vaginal+cyst&pg=PA220|url-status=live}}</ref><ref>{{cite journal|vauthors=Hoogendam JP, Smink M |date=April 6, 2017|title=Gartner's Duct Cyst|journal=New England Journal of Medicine|volume=376|issue=14|pages=e27|doi=10.1056/NEJMicm1609983|pmid=28379795}}</ref> A vaginal cyst is most likely to develop in women between the ages of 30 and 40.<ref name=lall/> It is estimated that 1 out of 200 women has a vaginal cyst.<ref name= lall/><ref name="Marisa R.">{{Cite book|url=https://books.google.com/books?id=r7EOW0jm2CoC&q=Vaginal+cyst&pg=PA96|title=Gynecologic Pathology|vauthors=Nucci MR, Oliva E|date=January 1, 2009|publisher=Elsevier Health Sciences|isbn=978-0-443-06920-8|pages=96|language=en|access-date=October 19, 2020|archive-date=March 10, 2021|archive-url=https://web.archive.org/web/20210310000420/https://books.google.com/books?id=r7EOW0jm2CoC&q=Vaginal+cyst&pg=PA96|url-status=live}}</ref> The [[Bartholin's cyst]] is of vulvar rather than vaginal origin,<ref name="Robboy 2">{{cite book|vauthors=Robboy SJ|title=Robboy's Pathology of the Female Reproductive Tract|publisher=[[Elsevier Health Sciences]]|isbn=978-0-443-07477-6|year=2009|page=117|url=https://books.google.com/books?id=ab545XL-MBEC&pg=PA117|access-date=March 8, 2018|archive-date=July 3, 2019|archive-url=https://web.archive.org/web/20190703220034/https://books.google.com/books?id=ab545XL-MBEC&pg=PA117|url-status=live}}</ref> but it presents as a lump at the vaginal opening.<ref name="Marx">{{cite book|vauthors=Marx J, Walls R, Hockberger R|title=Rosen's Emergency Medicine - Concepts and Clinical Practice|publisher=[[Elsevier Health Sciences]]|isbn=978-1-4557-4987-4|year=2013|page=1314|url=https://books.google.com/books?id=uggC0i_jXAsC&pg=PA1314|access-date=February 24, 2015|archive-date=May 15, 2015|archive-url=https://web.archive.org/web/20150515033915/https://books.google.com/books?id=uggC0i_jXAsC&pg=PA1314|url-status=live}}</ref> It is more common in younger women and is usually without symptoms,<ref name="Cash">{{cite book|vauthors=Cash JC, Glass CA|title=Sternberg's Diagnostic Surgical Pathology, Volume 1|publisher=[[Springer Publishing Company]]|isbn=978-0-8261-5351-7|year=2017|page=425|url=https://books.google.com/books?id=9tRJDwAAQBAJ&pg=PA425|access-date=February 15, 2018|archive-date=July 3, 2019|archive-url=https://web.archive.org/web/20190703211347/https://books.google.com/books?id=9tRJDwAAQBAJ&pg=PA425|url-status=live}}</ref> but it can cause pain if an [[abscess]] forms,<ref name="Cash"/> block the entrance to the [[vulval vestibule]] if large,<ref name="Sternberg">{{cite book|vauthors=Sternberg SS, Mills SE, Carter D|title=Sternberg's Diagnostic Surgical Pathology, Volume 1|publisher=[[Lippincott Williams & Wilkins]]|isbn=978-0-7817-4051-7|year=2004|page=2335|url=https://books.google.com/books?id=TM5-h0Fo9_4C&pg=PA2335|access-date=February 15, 2018|archive-date=July 4, 2019|archive-url=https://web.archive.org/web/20190704044848/https://books.google.com/books?id=TM5-h0Fo9_4C&pg=PA2335|url-status=live}}</ref> and impede walking or cause painful sexual intercourse.<ref name="Cash"/>