A rare case of secondary gynaetresia after face-to-pubes birth managed by vaginoplasty

Abstract

Postpartum vaginal stenosis is an extremely rare but distressing complication following vaginal delivery. We report the case of a 25-year-old para 1 woman who developed secondary gynatresia after a face-to-pubes vaginal delivery complicated by extension of episiotomy and vaginal wall tears. The patient presented two months postpartum with inability to resume sexual intercourse. Examination revealed a fibrous constricting band at the vaginal introitus with markedly reduced vaginal caliber. She was successfully managed with surgical adhesiolysis and vaginoplasty followed by regular postoperative vaginal dilation. Early diagnosis and timely surgical intervention resulted in complete symptomatic relief. This case highlights the importance of careful repair of obstetric lacerations and vigilant postpartum follow-up to prevent long-term sexual morbidity.