Quote from "Pediatric Colorectal Conundrums: Case Studies: From Fundamental to Advanced (Pediatric Colorectal Surgery)" by Marc Levitt, Thomas Xu, Hussein Wissanji -

"For patients with uterine abnormalities, obstruction of menses is possible, and surgical correction may become necessary. Pregnancies in patients with vaginal anomalies are often considered high risk, and delivery options need to be discussed with maternal fetal medicine. The pelvic floor muscles are often not normally developed or have been iatrogenically altered, making vaginal delivery after pregnancy more traumatic. This is especially true if the perineal body was divided during reconstruction. Most patients with a history of anorectal and/or vaginal malformations are advised to use c-section as the mode of delivery."

quote from "Pediatric Colorectal Conundrums: Case Studies: From Fundamental to Advanced (Pediatric Colorectal Surgery)" by Marc Levitt, Thomas Xu, Hussein Wissanji -

"In patients who have had a vaginal replacement, the most common long-term complication is stenosis of the neovagina. This can often be diagnosed with an exam under anesthesia and managed with dilations but may require a revision. If bowel interposition was used for vaginal replacement, patients may experience prolapse of the interposition, excessive mucus production, bleeding, mal-odor, and dyspareunia. Malignancy of the bowel graft has been reported, as has inflammatory bowel disease, in the segment. These are the main reasons why bowel neovaginas nowadays are avoided. These complications are eliminated in patients bridged with buccal mucosa."