Congenital Genital Tract Malformations in Singapore

What is a Congenital Genital Tract abnormality?

The term congenital refers to abnormalities in genital tract present from birth in Singapore. A congenital genital tract, thus, refers to the abnormalities or anomalies identified in the female genital tract. It has been estimated that 4-7% of the female population in the world is affected by structural disorders of the reproductive tract.

Whilst uncommon, congenital disorders of the genital tract can have serious reproductive implications and have been reported to cause a lowered quality of life as it impacts various aspects of psychological and sexual health. There are various abnormalities that can occur on the genital tract and multiple classification systems have been constructed over the years to accurately grade these abnormalities.

Congenital genital disorder can occur in either the internal or external genitalia. The internal genitalia consists of the vagina, uterus, fallopian tubes, and ovaries. On the other hand, external genitalia encompasses the vulva and the various structures of its makeup such as the hymen, clitoris, and labia.

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Other abnormalities of the genital tract could also include:

Intersex or disorder of sex development
Ambiguous genitalia

Common causes of Congenital Genital Tract malformation in Singapore?

Congenital genital tract abnormalities are caused by defects during the embryologic phase.

Factors affecting these defects include:

Genetic defects: potential deviations or alterations such as disrupted gonadal development that have occurred in the developmental pathway during foetal development or puberty.
Hormone: prenatal exposure to androgens such as testosterone will cause genital malformations.

What are the symptoms of Congenital Genital Tract?

Symptoms of congenital genital tract include:

Menstruation problems: menstruation problems such as excessive bleeding during menstruation (menorrhagia), pain and cramps during menstruation (dysmenorrhoea), absence of menstruation by age 15 (amenorrhoea), and menstrual flow despite using tampons (signs of a second vagina) are symptoms of congenital genital tract.
Pain: such as sharp pain and discomfort during and after intercourse, abdominal and pelvic pain that develops and is persistent during or post-puberty, and menstruation-cramps and pain even when not menstruating are symptoms of congenital genital tract.
Reproductive disorders: characterised by infertility, difficulties conceiving, and frequent miscarriages are symptoms of congenital genital tract.
Visible body abnormalities: examples include, lack of breast development, lack of opening in the labia, and genitals that seem to be a mixture of the structure of male and female genitalia.
Urinary incontinence: such as overflow incontinence where the urinary bladder does not completely empty leading to uncontrollable urine dribbles are characteristic of a congenital genital tract.

If you notice any of the symptoms stated above, make an appointment today to get an accurate diagnosis and effective treatment.

Is Congenital Genital Tract painful?

Congenital genital tract disorders can be painful depending on which region of the reproductive tract is impacted. Where obstructive genital tract is present, endometriosis – a painful period condition may occur. Additionally, abnormalities could also manifest as pain during intercourse. In hindsight, it is possible that no pain symptoms occur and abnormalities are only discovered when attempting to conceive or when investigating the cause of frequent miscarriages.

Who is at risk of Congenital Genital Tract abnormalities in Singapore?

Most congenital genital tract abnormalities are of unknown cause or etiology. Some may be associated with the condition of the mother during pregnancy.

Certain factors that may cause congenital genital abnormalities include:

Family history: congenital abnormalities are generally presumed to be prevalent when other family members are diagnosed with the same condition. However, it is unknown if congenital genital tract disorders are specifically inherited.
Environmental effects: maternal exposure to pollutants, radiation, or infection may be a potential cause of congenital issues.
Malnourishment during pregnancy: mothers who are malnourished or have nutrient deficits may increase the likelihood of underdevelopment of foetal growth.
Substance abuse or use during pregnancy: indulging in alcohol, drugs, and cigarettes may result in deviation of foetal development.
Underlying health conditions: health conditions such as obesity and metabolic disorders increase androgen levels which may subsequently cause congenital genital tract in babies.

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How is Congenital Genital Tract abnormality diagnosed?

It is possible that external congenital tracts abnormalities are identified at birth. Paediatricians will be able to determine any physical abnormalities during the physical examination of babies upon birth. However, most other abnormalities are usually detected at reproductive ages. This may be due to abnormalities present at the internal genitalia region or manifestation of issues during puberty.

Diagnosis of congenital genital tract may include:

Physical examination: your obstetrician/gynaecologist may attempt to identify any external genitalia abnormalities. This would include a pelvic examination and pubertal development assessment.
Imaging tests: such as a pelvic magnetic resonance imaging (MRI) will provide a clearer visualisation of the genital tract, thus, enabling the identification of abnormalities. Ultrasound too, enable the identification of any structural abnormalities.
Blood tests: required to measure hormone levels and investigate potential gonadal dysfunction.
Diagnostic laparoscopy: a laparoscopy may be conducted if abnormalities are evasive or other diagnostic measures do not provide sufficient explanation for the occurrence of the congenital genital tract.

What are the treatment options for Congenital Genital Tract in Singapore?

Treatment options for congenital genital tract include:

Surgery: surgeries are the common method employed to correct congenital genital tract abnormalities. Laparoscopic surgery may be employed as a fertility treatment if patients are struggling with conception issues.
Non-surgical treatment: a vaginal canal is created with a dilator device to stretch and widen the vaginal area.
Oral medication: anti-inflammatory drugs are prescribed to alleviate pain. These, however, do not cure or improve congenital genital tract issues.
Hormone therapy and contraceptives: depending on your condition, appropriate hormone therapy would be suggested. Contraceptives would potentially be prescribed to address any menstrual problems.

Frequently asked questions

What are my options if my congenital genital tract cannot be corrected to conceive a child?

If there is no treatment solution for a given congenital genital tract, alternative methods of reproduction may be advised. Depending on the specific abnormality, the methods employed may vary.

Congenital Genital Tract Malformations