The vagina may be imperforate in its entire length or only partially. There may be a septum dividing the canal in two; such a condition is usually associated with a double uterus. Stenosis is seldom congenital; is generally secondary to some ulcerative condition.

When there has been a loss of support, as from a torn perineum, there may be a prolapse of the vagina, usually of the anterior wall. As the tissues relax the bladder is gradually involved; it is dragged downward and appears as a bulging of the vaginal wall - a vaginal cystocele. If the posterior wall prolapses and drags in the rectum, it is known as a vaginal rectocele.

Wounds may result from the introduction of foreign bodies, from coitus, or from injury during childbirth. If the injury or destruction to the part has been severe, fistula may be established between the vagina and neighboring structures. Communication between the bladder is known as a vesicovaginal fistula; with the urethra, urethrovaginal; with the rectum, rectovaginal. Severe secondary inflammations may result from infection by urine or feces.

Inflammation of the vagina, vaginitis or colpitis, may be due to injury, as from hot douches, to the presence of foreign bodies, to the oxyuris, or to gonorrhea. In mild attacks there is a simple catarrhal inflammation, the mucous membrane becomes reddened, swollen, and covered by a slight alkaline mucopurulent secretion. In the gonorrheal form the reactions are more severe, the discharge is more purulent, and the cervix and urethra are generally involved. Occasionally when the inflammation is of a very high grade the mucosa may be exfoliated, almost as a cast of the vagina. A pseudo-membrane may be formed in the course of pneumonia, pyemia, and other infectious diseases. The mucous surface is covered by a dirty grayish pseudo-membrane that is eventually cast off, leaving quite extensive ulcerations. This may be followed by necrosis of the vaginal walls.

Chronic vaginitis or leukorrhea may follow acute attacks or be the result of constitutional disturbances. Is commonly known as "the whites," on account of the presence of a thick, creamy exudate, acid in reaction. The mucosa is reddened and swollen, and resembles the condition seen in acute vaginitis. The discharge at times is thinner and contains less pus. Some-times there may be marked thickening of the vaginal mucosa with very little discharge.

Tuberculosis of the vagina is secondary to similar disease of either the uterus - in which case it appears as rounded ulcers - or if of the vulva it is in the form of lupus.

Syphilis of the vagina is unusual. It may appear as a chancre, a mucous patch, or in the form of ulcers. Gummata may form and through regeneration give rise to distortion of the vagina as the scar-tissue heals.


Fibromata or fibromyomata are found in the submucous and muscular layers as either projecting nodules or as polyps. Sarcomata are rare. Papillomata are fairly common. Carcinoma is usually secondary to cancer of the cervix or of the rectum. When primary, is usually of the squamous epithelioma variety and cauliflower-like in its growth.

Cysts of the vagina are usually the result of obstructions of the follicles. They are generally small and may be single or multiple. Some of the larger cysts may develop from remains of the Wolffian or Müllerian ducts. May also be the result of lymphangiectasis.