In rare cases the vagina is missing altogether; this condition is usually accompanied by various congenital disorders. Congenital cysts occur regularly in the wall of the vagina and are harmless. A septum can also occur in the vagina. Sometimes the hymen is rigid and has no opening, preventing the passage of menstrual blood. Such disorders do not usually come to light until puberty. Some of them can be remedied by surgery. Abnormalities within the vagina usually occur later. The commonest is vaginitis, usually accompanied by vaginal discharge1” and itching of the vulva. After the menopause, the mucous membrane can become thin and dry (vaginal atrophy), causing discomfort. Benign vaginal tumours occur rarely, and cancer of the vagina more rarely still. When the vaginal wall becomes too weak, the bladder and rectum can protrude into the vagina (cystocele and enterocele). This mainly occurs after several difficult childbirths. Prolapse of the womb can also occur because the pelvic floor muscles have slackened. It is then difficult to retain the urine. This condition may be remedied by means of a pessary, but sometimes an operation is necessary.