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Vaginal reconstruction is generally required because of lack of a vagina from birth, congenital hormone defects or sex change. The majority of patients with Rokitansky's Syndrome, the main cause of congenital absence of a vagina, also have no womb at birth. There may be a short vagina formed from the urogenital sinus. Ovary functions are normal in this syndrome of unknown cause. It generally appears with inability to menstruate and engage in sexual relations. Patients need to undergo surgery in order for a vagina of normal length permitting sexual relations to be formed. Various techniques are employed in surgery. Skin or bowel segment transfers can be used. Despite the attendant difficulties, reconstruction with a bowel segment is a technique that provides almost ideal results, and can only be performed in certain centers. But an appropriate method can be determined for all patients. It is therefore of the greatest importance for the patient and doctor to discuss the subject in detail and agree on the most appropriate technique in order for the patient to enjoy a happy and problem-free life.