Normalization of the vagina by dilator treatment alone in Complete Androgen Insensitivity Syndrome and Mayer-Rokitansky-Kuster-Hauser Syndrome.

Abstract

BACKGROUND:

Various surgical and non-surgical treatment options are available for women with congenital vaginal agenesis. We report results of vaginal dilation therapy delivered by a multi-disciplinary team as first line treatment for vaginal agenesis.

METHODS:

Twenty-six women were recruited into a prospective observational study: 18 had Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) and 8 had Complete Androgen Insensitivity Syndrome (CAIS). All women underwent a vaginal dilation programme co-ordinated by a clinical nurse specialist with input from a clinical psychologist. Vaginal length was compared to a normal reference range, and psycho-sexual questionnaires were completed before and after therapy.

RESULTS:

Twenty-one (81%) patients completed the programme. Seventeen of these 21 (81%) were sexually active without any reported difficulties, whereas 4 were on a maintenance regime. In those who completed the programme the mean vaginal length increased from 4.0 to 8.5 cm and 86% achieved a vaginal length within the normal range. Subjective appraisal of vaginal size recorded that the number of women who reported that their vaginal size was 'more or less normal' increased from 1 to 12 following treatment. Questionnaire scores for sexual satisfaction and sexual depression improved in the CAIS group but did not alter significantly in the MRKH group.

CONCLUSION:

Non-surgical dilation delivered by a multi-disciplinary team is an effective alternative to vaginal surgery and usually normalizes vaginal length.

• Authors: Ida S Ismail-Pratt, Maligaye Bikoo, Lih-Mei Liao, Gerard S Conway, Sarah M Creighton
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 22 Issue 7 Pg. 2020-4 (Jul 2007) ISSN: 0268-1161 [Print] England
• PMID: 17449508 (Publication Type: Journal Article)

Chemical References

• Androgens

Topics

• Adult
• Androgen-Insensitivity Syndrome (therapy)
• Androgens (metabolism)
• Female
• Genitalia, Female (abnormalities)
• Humans
• Male
• Patient Satisfaction
• Prospective Studies
• Sexual Behavior
• Surgically-Created Structures
• Surveys and Questionnaires
• Treatment Outcome
• Vagina (abnormalities, anatomy & histology, pathology)