A vaginal blockage refers to any physical obstruction or narrowing within the vaginal canal that can impede its normal function or passage. Such blockages can arise from various origins, ranging from conditions present at birth to those acquired later in life.
Structural Abnormalities Present at Birth
Some individuals are born with structural differences in the vagina that can lead to a blockage. One such condition is an imperforate hymen, where the hymen completely covers the vaginal opening, leaving no space for menstrual flow or other discharge to exit. This can lead to a buildup of menstrual blood in the vagina and potentially the uterus, causing pain and abdominal swelling.
Another congenital cause is a transverse vaginal septum, which is a wall of tissue running horizontally across the vaginal canal. This septum divides the vagina, creating a blockage that can be complete or partial. A complete septum prevents any fluid from passing, while a partial septum may have a small opening, allowing some menstrual flow but potentially prolonging periods or causing blood to back up. The formation of a transverse vaginal septum occurs when the two parts that normally fuse to create the vagina do not join properly during fetal development.
Vaginal atresia or agenesis are more severe congenital conditions where the vagina is either underdeveloped, partially closed, or entirely absent. In vaginal atresia, the lower portion of the vagina may consist of fibrous tissue, or the canal may be partially or completely closed. Vaginal agenesis, by contrast, means the vaginal canal never formed at all. These conditions often become apparent during puberty when menstruation does not begin as expected, or when menstrual blood accumulates, causing abdominal pain.
Foreign Objects
Foreign objects introduced into the vagina can also lead to blockages. Commonly, forgotten tampons are a cause. A tampon can become lodged high in the vaginal canal, making it difficult to retrieve, particularly if the string is not easily accessible or if a new tampon is inserted before the old one is removed. Its presence can still cause an obstruction.
Other items, such as contraceptive devices like diaphragms or cervical caps, can become lodged and cause a blockage. Fragments of medical devices, or even small, non-medical items inserted intentionally or unintentionally, may also become trapped. These foreign bodies can directly block the vaginal canal, or their presence can lead to secondary issues such as swelling, inflammation, or infection. Prolonged retention of foreign objects can also cause irritation and discharge.
Tissue Growths and Lesions
Various biological growths or lesions can develop within or near the vaginal canal, leading to a physical blockage. Benign growths can obstruct the passage if they grow large enough or are located in a way that narrows the canal. Vaginal cysts, such as Gartner’s duct cysts or Müllerian cysts, can form on the vaginal walls. These fluid-filled lumps can narrow the vaginal space.
Bartholin’s cysts, which occur when the ducts of the Bartholin’s glands near the vaginal opening become blocked, can also grow to a size that causes partial obstruction. Fibroids, which are typically benign muscular tumors, and polyps, small tissue growths, can also develop in the vaginal area. If these growths protrude into the vaginal space, their size and position can obstruct the passage.
Malignant tumors, specifically vaginal cancer, represent another cause of tissue growth leading to blockage. Cancerous growths can expand within the vaginal canal. Its growth can be aggressive and lead to significant obstruction.
Inflammation and Scar Tissue Formation
Severe inflammation or the development of scar tissue can also lead to a vaginal blockage. Acute inflammation resulting from severe infections, such as certain sexually transmitted infections or severe vaginitis, can cause significant swelling of the vaginal walls. This swelling temporarily narrows the canal.
More lasting obstructions can arise from scar tissue, also known as vaginal adhesions or synechiae. This tissue can form as a result of trauma, such as injuries during childbirth, or following surgical procedures like episiotomy repair or hysterectomy. Radiation therapy to the pelvic area, often used in cancer treatment, is a known cause of vaginal stenosis, where scar tissue forms, leading to the tightening and shortening of the vagina. The formation of synechiae is often linked to chronic irritation or inflammation, where epithelial cells may denude and then adhere.
This scar tissue can contract, narrowing the vaginal canal or even causing parts of the vaginal walls to fuse together. The severity of the obstruction can range from partial narrowing to complete fusion, leading to a full blockage.