Vaginal agenesis in MRKH syndrome: integrating surgical technique with long-term psychosexual support

A woman in the early 30s presented with primary amenorrhoea and absence of vaginal canal, seeking surgical correction as she wished to get married. Further evaluation led to a diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome. She had normal ovarian function and well-developed secondary sexual characteristics. The absence of a functional vagina had caused significant emotional distress, including anxiety, low self-esteem, a sense of incompleteness and social stigma related to marriage. Following confirmation of the diagnosis, a multidisciplinary team successfully performed McIndoe vaginoplasty using a custom-made collapsible mould and a split-thickness skin graft, creating an 8 cm long neovagina. The patient recovered well, regained self-esteem, married and now enjoys a fulfilling personal life, underscoring the transformative impact of coordinated care in such rare congenital anomalies.